• Medicaid Provider Hospital

    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 (10/21/25)
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  • Senior Provider Contracting Professional…

    Humana (Raleigh, NC)
    …and reimbursement rates to providers in building and maintaining Medicaid Behavioral Health provider networks. Analyzes the financial impact(s) of ... Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other Behavioral Health contracts and agreements within the… more
    Humana (09/25/25)
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  • Medicare (PPS) Provider Hospital

    Humana (Raleigh, NC)
    …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 (10/18/25)
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  • Provider Contracting Professional 2

    Humana (Raleigh, NC)
    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 (10/17/25)
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  • Senior Provider Contracting Professional

    Humana (Raleigh, NC)
    …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
    Humana (10/15/25)
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  • Reimbursement Case Manager

    TEKsystems (Morrisville, NC)
    …are not specifically set-forth in this job description. Skills reimbursement , insurance, medical, insurance verification, prior-authorization, benefits, provider ... Reimbursement Case Manager + Will serve as an...types of major payers including private/commercial and government (Medicare, Medicaid , VA, DoD) + Maintains records in accordance with… more
    TEKsystems (10/21/25)
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  • Inpatient Medical Coding Auditor

    Humana (Raleigh, NC)
    …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
    Humana (09/24/25)
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  • Jpap Care Coordinator Reverification Blizzard

    TEKsystems (Morrisville, NC)
    …other forms of available support and will be responsible for handling healthcare provider and/or patient interactions May serve as an advocate to patients regarding ... offered by all payer types including private/commercial and government (ie, Medicare, Medicaid , VA and DOD); with expertise in Medicare Part B Navigates through… more
    TEKsystems (10/11/25)
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  • Jpap Care Coordinator Reverification Blizzard

    TEKsystems (Morrisville, NC)
    …smooth interactions and timely resolutions across all payer types-including Medicare, Medicaid , VA, and commercial insurance-with a strong focus on Medicare Part ... support + Handle inbound and outbound communications to resolve access and reimbursement issues + Maintain accurate records and escalate complex cases per program… more
    TEKsystems (10/08/25)
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  • Jpap Care Coordinator Reverification Blizzard

    TEKsystems (Morrisville, NC)
    …knowledgeable resource on insurance benefits across all payer types (private, commercial, Medicare, Medicaid , VA, DOD), with a strong focus on Medicare Part B. + ... liaison between healthcare providers, internal teams, and program management. + Provide detailed program information and maintain accurate records in compliance with… more
    TEKsystems (10/08/25)
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  • Nurse Audit Manager

    Humana (Raleigh, NC)
    …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
    Humana (10/18/25)
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