- Humana (Sacramento, CA)
- …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 (Sacramento, CA)
- …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to… more
- Scripps Health (San Diego, CA)
- …billing and reimbursement procedures and practices. * Working knowledge of hospital UB04, CPT-4, HCPCS, ICD-10 and Revenue codes. * Proficient in institutional ... the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …DRG/APC reimbursement table. Responsible for financially counseling patients at hospital bedside. Work closely with Case Management (UR) daily in regards to ... About Us Bakersfield Behavioral Healthcare Hospital , located in Bakersfield, California, is an acute...commercial, Managed care, government plans and State programs, ie Medi-Cal/ Medicaid and CCS. The Patient Account Rep is responsible… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Assistant General Counsel - Hospital Operations must be a transactional/regulatory attorney ... both the corporate and local levels across the health system. This attorney will provide daily counsel on a range of operational issues. This attorney will prepare a… more
- UCLA Health (Los Angeles, CA)
- …role at one of the nation's top academic health systems. As Director of Reimbursement , you'll play a pivotal role in maximizing reimbursement and ensuring ... Reagan UCLA Medical Center, UCLA Santa Monica Medical Center, UCLA Mattel Children's Hospital , and Resnick Neuropsychiatric Hospital -as well as a vast network of… more
- UCLA Health (Los Angeles, CA)
- …conversion factors. + In-depth knowledge of professional and hospital Medicaid , Medicare, and commercial managed care reimbursement structures. Leadership & ... assess the competitive healthcare landscape, payer/ provider dynamics, and evolving reimbursement methodologies. * Provide insights on emerging trends in… more
- LA Care Health Plan (Los Angeles, CA)
- …Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's ... the right place at the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income… more
- Sharp HealthCare (San Diego, CA)
- …American Health Information Management Association (AHIMA); Certified Procedural Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC); HS ... and APC's) as mandated. Uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, HCAL data financial and… more
- Stanford Health Care (Palo Alto, CA)
- …planning, leadership, and operations support for Health Information Management, Hospital and Professional Coding Services, Charge Capture procedures, Revenue ... revenue capture and clinical documentation is effective in optimizing all Technical ( hospital ) and Professional revenue and quality measures outcomes. Acts a liaison… more
- LA Care Health Plan (Los Angeles, CA)
- …Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's ... the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles...Review, approve and suggest revisions on policies and procedures, member/ provider materials, compliance work plans, etc., as well as… more
- Sutter Health (Burlingame, CA)
- …of care, and observation status. + Some awareness of healthcare reimbursement systems: Health Maintenance Organization (HMO), Preferred Provider Organization ... **Position Overview:** The Physician Advisor (PA) is a key member of the hospital 's leadership team charged with meeting the organization's goals and objectives for… more
- UCLA Health (Los Angeles, CA)
- …UB-04, HCPCS, MS DRG, CPT, etc.) * Familiarity with Commercial, Medicare, and Medicaid reimbursement * Ability to write SQL and other coding languages ... ensure the consistent delivery of the highest quality of care within California's #1 hospital . Take your professional expertise to the next level. UCan do all this… more
- Humana (Sacramento, CA)
- …to quality review the inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to… more
- Dignity Health (Bakersfield, CA)
- …health; and ensuring efficient resource utilization, quality outcomes, and optimized reimbursement . The position requires the ability to understand and develop ... management, and/or social services. Must have a working knowledge of hospital and/or post-acute care operations, medical/nursing staff procedures, hospital … more
- Robert Half Office Team (Rancho Cordova, CA)
- …determine when to prompt physicians for more complete documentation affecting hospital reimbursement . * Accurately and effectively identify missing documentation ... medical documentation, communication with medical staff, and ensuring appropriate reimbursement for the hospital reflecting the complexity and severity… more
- Sanofi Group (San Francisco, CA)
- …+ Maintain extensive knowledge of the Managed Care, GPOs, Specialty Pharmacy, State Medicaid and Veterans Affairs selling and reimbursement environment for their ... the promotion of Belumosudil in their assigned geography. The IHM will provide on-label product information to designated key opinion leaders, health care… more
- Abbott (Livermore, CA)
- …high employer contribution + Tuition reimbursement , the Freedom 2 Save ... The Joint Commission (TJC) accreditation experience (eg, Home Health, DME, Ambulatory, Hospital , etc.). + Experience or knowledge of Medicare (eg, IDTF, DMEPOS) and… more
- Alameda Health System (Oakland, CA)
- …address any gaps in documentation that may affect proper classification or reimbursement . 14. Provide real-time feedback and education to clinicians regarding ... System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / Per Diem -… more
- Novo Nordisk (Bakersfield, CA)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... strategies + May develop and utilize relationships with specialists, key hospital decision-makers, and other individuals who make or influence the purchasing,… more