- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
- Deloitte (Columbus, OH)
- …consulting services to public sector clients + Support engagements focused on Medicaid reimbursement , including actuarial rate development across managed care ... and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, etc.) + Experience with… more
- Elevance Health (Columbus, OH)
- … Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare… more
- Humana (Columbus, OH)
- …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... sales. The MarketPoint Strategy Advancement team is searching for a Senior Strategy Advancement Professional focused on continuous improvement and optimization… more
- Cardinal Health (Columbus, OH)
- …preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid preferred + Experience with computerized billing software ... requirements and accounts assigned + Works closely with insurance carriers for reimbursement requirements to ensure payment + Reviews outstanding AR accounts and… more
- Centene Corporation (Columbus, OH)
- … Medicaid . + Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. + ... President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies...the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid… more
- Molina Healthcare (Columbus, OH)
- …in Business, Health Administration, or related field. **Preferred Experience** Experience with Medicaid and Medicare managed care plans. \#PJHPO \#LI-AC1 To all ... Provider Network Management and Operations Department. Works with staff and senior management to develop and implement provider contracting and service strategies… more
- Humana (Dublin, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives + Proven planning, preparation and presenting… more
- Cardinal Health (Columbus, OH)
- …and/or hospital facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines; ... billing standards; communication of audit results to physicians, physician leadership, senior leadership, management, and staff; physician and coder education; and… more
- Baylor Scott & White Health (Columbus, OH)
- …and senior medical staff including denials from all payers, Medicare / Medicaid audit activities and key contract enforcement activities. + Collaborates ... to improve appeal success rates, ensure regulatory compliance and optimize reimbursement outcomes. Will lead external resources through vendor or contractor… more
- Cardinal Health (Columbus, OH)
- …preferred. + Strong understanding of medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare , Medicaid ). + Proven ... recommend and implement preventive measures. + Prepare and present reports to senior leadership on collection performance, trends, and areas for improvement. +… more
- Prime Therapeutics (Columbus, OH)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs,… more