- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- Molina Healthcare (Atlanta, GA)
- …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development… more
- Humana (Atlanta, GA)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
- Humana (Atlanta, GA)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... + 2+ years of network management experience including but not limited to: provider and hospital contracting, network administration in a healthcare company or… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …healthcare and transplants preferred. + Strong knowledge of Medicare and Medicaid reimbursement regulations. + Excellent analytical and problem-solving skills. ... preparing to report on all supplemental Federal and State reimbursement matters + Coordinates Medicare and Medicaid ...with priority focus on billing changes impacting physician and hospital chargemasters + Assist with Provider based… more
- Emory Healthcare/Emory University (Duluth, GA)
- …you to reach new heights in your careerand be what you want to be. We provide : + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & ... Reimbursement Programs + Family-focused benefits + Wellness incentives +...+ Communicates confidently and effectively with all levels of hospital staff, physicians and payors; + Is assertive without… more
- Cardinal Health (Atlanta, GA)
- …audit methodology, principles and techniques; CMS manuals; professional and/or hospital services reimbursement and repayment; confidentiality standards. + ... organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and correction of documentation,… more
- Emory Healthcare/Emory University (Duluth, GA)
- …screening process to patients, patients families, and legal guardians in a hospital setting. + Secure maximum reimbursement through up front identification ... career and be what you want to be. We provide : + Comprehensive health benefits that start day 1...start day 1 + Student Loan Repayment Assistance & Reimbursement Programs + Family-focused benefits + Wellness incentives +… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …three (3) years' of healthcare experience in Managed Care Contracting, Hospital Reimbursement , Professional Reimbursement , Denials, and/or ... career and be what you want to be. We provide : + Comprehensive health benefits that start day 1...Ten (10) years' of experience in Managed Care Contracting, Hospital Reimbursement , Professional Reimbursement , Denials,… more
- Waystar (Atlanta, GA)
- …of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare ... Integrity products + Ability to interpret regulatory guidelines from CMS, Tricare, and Medicaid websites + Ability to understand the vocabulary used in hospital … more
- Humana (Atlanta, GA)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …to reach new heights in your career and be what you want to be. We provide : + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & ... Reimbursement Programs + Family-focused benefits + Wellness incentives +...reporting activities comply with the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and… more
- Gentiva (Alpharetta, GA)
- …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… more
- Humana (Atlanta, GA)
- …ensure medical documentation and coding are precise, compliant, and support optimal reimbursement . This is an exciting opportunity to apply your advanced technical ... Applies clinical and coding experience to conduct reviews of provider codes and billing. + Decisions are typically related...or more years of clinical RN experience in a hospital setting. + 3 or more years of experience… more
- Emory Healthcare/Emory University (Decatur, GA)
- …to reach new heights in your career and be what you want to be. We provide : + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & ... Reimbursement Programs + Family-focused benefits + Wellness incentives +...implications of medical intervention on the patient and healthcare provider . + Constantly seek and maintain knowledge of new/existing… more
- Waystar (Atlanta, GA)
- …workers to hospital executives. + Requires working knowledge of hospital billing practices, payer reimbursement methodology, medical necessity criteria, and ... Lead several managers focused on driving high revenue leakage findings for our Hospital Charge Integrity and DRG clients + Support managers with client communication… more
- Waystar (Atlanta, GA)
- …of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare ... hospitals and health systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out our organizational values:… more
- Emory Healthcare/Emory University (Duluth, GA)
- …to reach new heights in your career and be what you want to be. We provide : + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & ... Reimbursement Programs + Family-focused benefits + Wellness incentives +...insurance information for preregistration/registration on all patients. + Communicates hospital 's financial policies to all patients. + Identifiespatients whorequireearly… more
- PruittHealth (Atlanta, GA)
- …levels of care. 2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 3. ... continuum and facilitating admissions into the Pruitt Health network. 5. Must provide excellent customer service to all referral sources and network of providers.… more