- Humana (Springfield, IL)
- …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 (Springfield, IL)
- …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
- Humana (Springfield, IL)
- … 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 (Springfield, IL)
- …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
- Genesis Healthcare (Matteson, IL)
- …long term care clinical nursing experience is required. *Experience with Medicare/ Medicaid reimbursement , MDS completion, clinical resource utilization and/or ... of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in...RN manages the overall process and tracking of all Medicare/ Medicaid case-mix documents to ensure appropriate reimbursement … more
- Edwards Lifesciences (Chicago, IL)
- …in facility and physician's office or clinics. + Experience with government reimbursement programs, such as Medicare and Medicaid + Excellent project ... policy coverage for procedure and technology to seek broader access and adequate reimbursement . + Conduct virtual and onsite meetings with customers to educate on… more
- Option Care Health (Bannockburn, IL)
- …and abuse, including but not limited to HIPAA, Anti-Kickback, Stark, Medicare/ Medicaid reimbursement . + Experience evaluating information to determine compliance ... and/or nursing compliance programs. + Direct experience applying knowledge of Medicare, Medicaid , and Managed Care reimbursement guidelines. + Proficiency with… more
- Cardinal Health (Springfield, IL)
- …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
- Humana (Springfield, IL)
- …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
- Trinity Health (Maywood, IL)
- …Development + Tuition Reimbursement + On Site Fitness Center (Gottlieb Memorial Hospital & LUMC) + Certification reimbursement (up to 1 certification) + ... Loyola University Medical Center and is part of a three- hospital system including Loyola University Medical Center (https://www.loyolamedicine.org/location/lumc) ,… more
- Gentiva (Peoria, IL)
- …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
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital : Rush University Medical Center Department: Revenue Cycle Enterprise Svcs ... school graduate. * 5 years of experience working with hospital billing system with focus on Customer Service and...* Ability to analyze all forms of Commercial, Medicare, Medicaid , and Blue Cross explanation of benefits. * Ability… more
- Humana (Springfield, IL)
- …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
- SSM Health (Centralia, IL)
- …more than a career, it's a calling.** IL-SSM Health St. Mary's Hospital - Centralia **Worker Type:** Regular **Job Highlights:** **_Part Time Position-20 hours ... the posted range as permitted by law. **Job Summary:** Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans.… more
- Grifols Shared Services North America, Inc (Rockford, IL)
- …to fulfill customer needs and impact pull through, eg MSL, Nurse educator, reimbursement specialist. Gather and provide customer insights to Marketing teams for ... over the world. Our four divisions - Bioscience, Diagnostic, Hospital and Bio Supplies - develop, produce and market...of disease state knowledge as well as treatment approaches. Provide branded product and clinical insights aligned with the… more
- Ascendis Pharma (IL)
- …interest and capabilities assessment tool for HEOR research concept development. + Provide scientific input and participate on strategic HEOR planning teams and ... US payers, including both commercial and public payers such as Medicare and Medicaid . + Collaborate with commercial and medical in responding to external value… more
- Prime Healthcare (Chicago, IL)
- Overview Join our team of dedicated professionals who provide services and operational support to award winning hospitals through roles in supply chain, IT and ... engineering, capital procurement, medical coding, project management and more. We provide services to clinically excellent community hospitals across the country… more
- Philips (Rosemont, IL)
- …Philips Biomed/Clinical Engineering program which includes Centers for Medicare & Medicaid Services (CMS), FDA and accreditation agencies. + Drive new initiatives ... in an office/home office and/or remote setting, as well as in a hospital /healthcare environment; adhere to requirements. + Work flexible hours (based on business… more
- Rush University Medical Center (Chicago, IL)
- …ICD-9, ICD-10 and CPT coding. *Experience with the Center for Medicare and Medicaid regulations and 3rd party reimbursement . *Coding Certification thru AAPC or ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital : Rush University Medical Center Department: PB Revenue Integrity **Work… more