- Humana (Raleigh, NC)
- …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 (Raleigh, NC)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Humana (Raleigh, NC)
- …executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and ... responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to… more
- Edwards Lifesciences (Raleigh, NC)
- …They will work directly with hospital leaders and physicians to deliver hospital economic analyses customized to each provider . This individual will also ... of reimbursement plans (coding, coverage, payment) unique to each provider . + Articulate a thorough understanding of the structural heart landscape, trends,… more
- Cognizant (Raleigh, NC)
- We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United ... Monday to Friday - Eastern Time **About the role:** Asan AR Physician Hospital Billing Follow Up, you will be responsible for resolving aged hospital… more
- Guidehouse (Raleigh, NC)
- …and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. **This position is 100% ... for charge reconciliation audits + Escalate departments noncompliant with policy and provide action plan when needed + Responsible for the daily resolution of… more
- Gentiva (Henderson, NC)
- …designated teams and functions as an interdisciplinary (IDG) team member to provide care and liaise between physician, patient/family and hospice team. + Performs ... minimum of one (1) year experience as an RN, either in acute care hospital , oncology, long-term care, hospice or home health. + In instances where state-specific… more
- PruittHealth (Raleigh, NC)
- …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