- Humana (Columbus, OH)
- …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 (Cleveland, OH)
- …* 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 (Cincinnati, OH)
- …contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting, ... etc. * Working experience with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business,… more
- Humana (Columbus, OH)
- …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
- Bon Secours Mercy Health (Cincinnati, OH)
- …responsible for providing critical analytical and reimbursement support for reimbursement functions including Medicare, Medicaid , or other third party cost ... health system or other relevant accounting/finance experience + Ability to research reimbursement or net revenue issues and provide practical interpretations and… more
- Bon Secours Mercy Health (Lorain, OH)
- …eligibility for care; understand and communicates Center for Medicare & Medicaid Services (CMS) medical necessity and admission criteria. Establishes rapport with ... hospital staff and physicians; serves as consultant/resource person for...(ELOS) appropriately (using insurance and industry guidelines). Qualified to provide thorough and detail-oriented assessment of patient needs and… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …an employee/manager required. + Demonstrated working knowledge of Medicare and Medicaid , Insurance Managed Care including documentation, coding, reimbursement ... Mercy Health's overall compliance audit and compliance responsibilities relative to hospital revenue cycle services performed for Bon Secours Mercy Health. *Please… more
- Centene Corporation (Columbus, OH)
- …experience. 2+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician's office or group setting. ... fresh perspective on workplace flexibility. **Position Purpose:** Recruit physician, hospital and ancillary service providers to sign network participation… more
- Trinity Health (Columbus, OH)
- …environment and provide first class service + Communicates with other hospital departments and/or physicians practice to obtain, provide or revise ... for information to other areas of the laboratory, as well as other hospital departments and physician practices. Interacts respectfully with other hospital … more
- Cleveland Clinic (Mayfield Heights, OH)
- …in working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys ... in working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys… more
- Trinity Health (New Albany, OH)
- …Primary job responsibilities include: -Answering phone calls -Welcoming patient and visitors - Provide wayfinding for hospital patients and guests Secondary job ... ICD-9 coding to ensure compliance with third party regulations. Understands Medicare, Medicaid and other third party information requirements and adheres to all… more
- Humana (Columbus, OH)
- …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
- Fresenius Medical Center (Youngstown, OH)
- …blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor ... vascular access during treatment including arterial and venous monitoring pressures provide appropriate intervention as needed document and report any unusual… more
- Grifols Shared Services North America, Inc (Cleveland, OH)
- …territory including major accounts and large players (ie, Commercial, Medicare, and Medicaid ) + Coordinate with Hospital SSR counterpart to understand the ... Grifols portfolio of plasma therapies. If a neighboring hospital does not have a formulary contract or use...needs and impact pull-through (eg, MSL, IG Nurse Educator, reimbursement specialist) + Gather and provide customer… more