- 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 (Augusta, 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
- Molina Healthcare (GA)
- …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
- Molina Healthcare (GA)
- …have issues or complaints (eg, problems with claims and encounter data, eligibility, reimbursement , and provider website). + Serves as a resource to support ... live in Georgia _** **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development,… 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
- Cardinal Health (Atlanta, GA)
- …Managed Care oversees the interactions that take place between payer and provider (s) to ensure optimal reimbursement including managed care contracting, ... Functions:** + Responsible for documenting and tracking all credentialing, re-credentialing, provider enrollment, and hospital privileging activities within the… 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
- 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
- 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
- Molina Healthcare (Augusta, GA)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Savannah, GA)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… 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
- HCA Healthcare (Savannah, GA)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... Center (HSC) staff, and shared service center departments. You will also provide support to coding leadership by coordinating coding and education activities within… 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 +...community resources. Maintains a thorough working knowledge of Medicare, Medicaid and private payer regulations and processes. Maintains broad… more
- HCA Healthcare (Savannah, GA)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the… more