- Humana (Trenton, NJ)
- …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
- Molina Healthcare (New York, NY)
- …* 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
- Centene Corporation (New York, NY)
- …the need for additional health plan providers + Manage and coordinate customized provider contracts and hospital contracts + Participate in physician and ... experience. Experience with state and federal health programs such as Medicaid and Medicare. Provider relations/contracting experience including solid… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Mount Sinai Health System (New York, NY)
- …experience and/or pharmacy insurance experience required. + Five years pharmacy reimbursement analysis and collection experience with Medicare, Medicaid , ... **Job Description** Provide analysis and demonstrate understanding of pharmacy revenue...for accuracy; provides necessary follow-up. * Communicates and resolves reimbursement issues to coordinate payer/ provider relations between… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Hackensack Meridian Health (Brick, NJ)
- …accordance with the privileges approved by the credentialing committee to provide high-quality, cost-effective patient care within their scope of practice. ... They will be a driving force to ensure patient hospital stay and care transitions are as smooth and...accountable. Need 2-3 years experience as an Advanced Practice Provider , preferably in acute care setting. Education, Knowledge, Skills… more
- Cardinal Health (Trenton, NJ)
- …understands the trends that affect current and future healthcare business models and reimbursement to make short and long term strategies. Will serve as an executive ... implements managed care contracting strategy including implementation of value-based reimbursement initiatives. Responsible for maintaining reimbursement strategy… more
- Hackensack Meridian Health (Brick, NJ)
- …in accordance with the privileges approved by the credentialing committee to provide high-quality, cost-effective patient care within their scope of practice. They ... goal achievement in patient experience and outcomes. They will provide clinical guidance to support the unit-based care managers,...They will be a driving force to ensure patient hospital stay and care transitions are as smooth and… more
- Weill Cornell Medical College (New York, NY)
- …and Medicaid Services (CMS), and other third party payers reimbursement and coding regulations. Submits recommended coding changes for approval by physicians. ... practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital /Weill Cornell Medical Center,… more
- Mount Sinai Health System (New York, NY)
- …Appeals Analyst position requires an in-depth knowledge of healthcare pricing/ reimbursement processes and procedures including institutional, as well as professional ... documenting, and reporting underpayment trends, payer updates, payer regulations, and provide feedback on workflow procedures pertaining to our negotiated contracts.… more
- Bristol Myers Squibb (New York, NY)
- …of Market Access and Cell Therapy technical expertise within both payer and hospital systems + Thorough knowledge of reimbursement , coding and billing across ... and reimbursement , inclusive of private Commercial coverage, Medicare, and Medicaid + Knowledge of health economics + Thorough knowledge of the healthcare… more
- Hunterdon Health Care System (Flemington, NJ)
- …activities of the claims processing and accounts receivables for the Acute Care billings ( hospital ) under the direction of the Director of the SBO. . Maintains an ... efficient billing process for all hospital ancillary areas. Maintains best practices with registration, billing,...seeks opportunities to give directions, answer a question, or provide information or reassurance to customers; Acts as a… more
- Humana (Trenton, NJ)
- …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
- Weill Cornell Medical College (New York, NY)
- …CPT, ICD-9, and ICD-10 coding. + Working knowledge of third party payor reimbursement - Medicare, Medicaid , Managed Care and commercial insurance. **Licenses and ... practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital /Weill Cornell Medical Center,… more
- CVS Health (Plainfield, NJ)
- …The care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective ... The care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective… more
- Weill Cornell Medical College (New York, NY)
- …knowledge of medical terminology. + Working knowledge of third-party payor reimbursement - Medicare, Medicaid , Managed Care and Commercial Insurance. ... practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital /Weill Cornell Medical Center,… more
- Genesis Healthcare (Huntingdon Valley, PA)
- Overview ABOUT GENESIS As the nation's leading provider of healthcare services from short-term to long-term and a wide variety of living options and professional ... you comfortable working cross-functionally with departments like **Admissions, Clinical Reimbursement , and Social Services** to maintain accurate and compliant… more
- Genesis Healthcare (Montgomeryville, PA)
- Overview **ABOUT GENESIS** As the nation's leading provider of healthcare services from short-term to long-term and a wide variety of living options and professional ... you comfortable working cross-functionally with departments like **Admissions, Clinical Reimbursement , and Social Services** to maintain accurate and compliant… more
- RWJBarnabas Health (Old Bridge, NJ)
- …in surgical scheduling and prior authorization in a medical office or hospital setting + Strong knowledge of medical terminology, CPT/ICD-10 codes, and insurance ... preferred and Microsoft Office Suite + Familiarity with commercial, Medicare, and Medicaid insurance plans + Excellent organizational and time management skills +… more