Medicare Specialist Job at CareerPaths NW (Tacoma)

Health Insurance Specialist

The purpose of the Patient Relations Analyst (PRA) at Oak Street Health is to ed...

Location

United States , Richmond

Salary:

21.10 - 40.90 USD / Hour

CVS Health

Expiration Date

May 25, 2026

Requirements

Computer Skills: Ability to quickly navigate and use multiple computer programs to include, but not limited to: Gmail, MS Word or Google Docs, Excel, etc.
US work authorization

Job Responsibility

Assist patients with navigating medicare and insurance issues which includes coverage, benefits, summaries, eligibility and getting the most out of their plan
Serve as internal resource in the clinic on insurance questions for providers and staff
Assist patients in navigating the healthcare system, help patients resolve medical bills inside and outside of Oak Street Health (advocate for the patient)
Gain the trust of Oak Street Health patients in an effort to properly advise them in their healthcare coverage
Manage the welcome visit and orientation process for new Oak Street Health patients
Educate patients on how to apply for public benefits, such as Public Aid, and Extra Help for prescription drugs
Support the clinic management team on operational activities as needed, including scheduling and billing
Provide exceptional customer service
Foster patient engagement through the design and execution of events, including center tours
Other duties as assigned

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources

Fulltime

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...

Location

United States , Princeton

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in a similar role
Proficient in benefit functions
Demonstrated expertise in billing functions
Experience in claim administration
Familiarity with collection processes
Ability to handle and resolve medical denials
Comprehensive knowledge of Medicare

Job Responsibility

Analyze and categorize outstanding claims based on payer, denial reason, and claim value
Investigate and take corrective action on unpaid, denied, or underpaid claims
Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
Submit corrected claims and formal appeals as required
Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
Maintain comprehensive records of all payer interactions
Identify the root causes of denials and implement best practices to prevent future issues
Suggest changes to workflow to enhance claim submission accuracy and speed
Conduct training for in-house billing teams on claim recovery strategies

What we offer

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan

Fulltime

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
Post HS education preferred
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution

Fulltime

Quality Reporting Specialist

The Quality Reporting Specialist plays a critical role ensuring practice and ACO...

Location

United States

Salary:

Not provided

Aledade, Inc.

Expiration Date

Until further notice

Requirements

1+ years experience in quality reporting in healthcare or health plan setting
Experience working within at least one (1) major Electronic Health Record system (athenaHealth, eCW, etc)
Comfortable exporting data, formatting and reporting out results (Excel or Google Sheets experience)
Able to work independently and prioritize deadlines
Track and communicate progress
escalate barriers to performance
Strong written and verbal communication skills
Strong attention to detail

Job Responsibility

Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient
Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with field team to assist guiding practices through gap closures
Submit documentation to health plans and employ optimal method in each practice (i.e., upload to payor portal, secure email, etc)
Coordinates Electronic Health Record (EHR) system access set-up & login management
Consult with market field team members on quality reporting strategy - providing relevant market updates and chart review feedback for assigned practices

What we offer

Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options

Fulltime

Credentialing Specialist Lead

The Credentialing Specialist Lead serves as the senior subject matter expert wit...

Location

United States , Long Island City

Salary:

30.00 - 32.00 USD / Hour

The Dermatology Specialists

Expiration Date

Until further notice

Requirements

3+ years of healthcare credentialing experience
dermatology or multispecialty experience preferred
Strong knowledge of CAQH, NPPES, Medicaid, Medicare, and commercial payer portals
Exceptional attention to detail, organization, and follow-through
Excellent communication and interpersonal skills
Proficiency in Excel and credentialing systems
experience with eClinicalWorks a plus

Job Responsibility

Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.)
Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs
Prepare, track, and submit enrollment applications accurately and within payer timelines
Monitor revalidation and re-credentialing schedules to ensure ongoing compliance
Serve as the primary point of contact for escalated payer or provider inquiries
Partner with internal billing and operations teams to ensure credentialing aligns with billing readiness
Maintain credentialing logs, dashboards, and internal trackers for reporting purposes
Assist in training and supporting new credentialing specialists, ensuring quality and consistency across workflows

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Responsible for professional and effective written and verbal communication with both internal and external customers
Compliant with all CHRISTUS Health, payer, and government regulations
Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines

Fulltime

Behavioral Health Specialist

The purpose of a Behavioral Health Specialist at Oak Street Health is to provide...

Location

United States , Philadelphia

Salary:

66575.00 - 142576.00 USD / Year

CVS Health

Expiration Date

March 16, 2026

Requirements

Master’s Degree in the field of mental health counseling/healing arts required from an accredited school (Social Work, Counseling, Marriage and Family Therapy, etc.)
Highest clinical level of license (or local equivalent)
Experience with screening for common mental health and/or substance use disorders
Experience with assessment and treatment planning for common mental health and/or substance use disorders
Familiarity with brief, structured intervention techniques (e.g., Motivational Interviewing, Behavioral Activation, Problem Solving, Cognitive Behavioral, etc.)
US work authorization

Job Responsibility

Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health Program
Screen and assess patients for common mental health and substance use disorders
Develop care plans and provide or facilitate referrals to Oak Street’s psychiatric consultant and/or external resources
Provide short-term counseling and evidence-based treatments
Coordinate care with Oak Street’s psychiatric consultant, including warm handoffs for telehealth visits and collaboration on care plans
Develop relationships with primary care teams and consistently communicate changes in behavioral health care plans
Accurate and timely documentation of patient encounters and counseling sessions in Oak Street’s electronic medical record
Participate in regional and organizational efforts to advance Oak Street’s Behavioral Health Program through workshops, feedback sessions, and surveys
Possibly covering multiple clinics, depending on the maturity and panel sizes of those clinics
Other duties, as assigned

What we offer

Mission-focused career impacting change and measurably improving health outcomes for Medicare patients
Paid vacation, sick time, and investment/retirement 401K match options
Health insurance, vision, and dental benefits
Opportunities for leadership development and continuing education stipends
New centers and flexible work environments
Opportunities for high levels of responsibility and rapid advancement

Fulltime

Billing Specialist

Robert Half is partnering with a healthcare client in the recruiting for a Billi...

Location

United States , Oconomowoc

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate or bachelor’s degree in accounting, finance, or a related field preferred
Minimum of 2-3 years of experience in billing, account receivables, accounting preferably within a healthcare or senior living environment
Familiarity with Medicare, Medicaid, and private insurance billing processes is strongly desired
Expertise with billing software and tools (e.g., point-of-sale systems, accounting software, or healthcare billing platforms)
Strong attention to detail and accuracy in financial data entry and reconciliation
Excellent customer service and communication skills, with the ability to address sensitive conversations professionally
Proficient in Microsoft Office Suite, especially Excel and Word
Knowledge of HIPAA and other relevant regulations governing billing and financial data confidentiality.

Job Responsibility

Prepare and process monthly resident billing statements for services, housing, and additional care
Ensure accurate calculation of fees, expenses, and adjustments based on contracts and service changes
Manage third-party billing, including Medicare, Medicaid, private insurance, and long-term care providers
Monitor accounts receivable and follow up on outstanding balances to ensure timely payments
Process incoming payments via check, electronic transfer, and credit card, applying them correctly to resident accounts
Work with residents and families to address billing questions, payment plans, and financial discrepancies
Maintain billing records that comply with federal, state, and local regulations, including HIPAA requirements
Stay updated on relevant Medicare and Medicaid billing guidelines to ensure compliance
Prepare and submit reports for audits and regulatory purposes as needed
Reconcile charges, payments, and account balances on a routine basis to ensure the accuracy of resident accounts

What we offer

403b retirement planning
FSA
tuition assistance
paid time off
paid holidays

Fulltime

Medicare Specialist

CareerPaths NW

Location:
United States , Tacoma

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 22, 2026

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Job Posted:
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