- 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 (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 (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 (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 (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
- 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
- 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
- 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 (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 (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
- 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