- Lyric (Newtown Square, PA)
- …health insurance payer or automated claims editing solution, as a payment, reimbursement or medical policy analyst , medical claims processor, chart ... demonstrated understanding of US health insurance payers including Commercial, Medicare , Medicaid (FFS and MCOs), third-party claims processing (including paper… more
- Humana (Nashville, TN)
- …a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part ... team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** With the Medicare Finance Mid-West Regional team, you will support the Medicare ... Regional Finance Lead, who works closely with the Medicare Regional President and Market leadership. + Participate in...pay, health insurance, 401K and stock purchase plans, tuition reimbursement , paid time off plus holidays, and a flexible… more
- Centene Corporation (Cheyenne, WY)
- …pricing and risk assessment to estimate outcomes. **In this Sr. Actuarial Analyst role, you will:** + Apply knowledge of mathematics, probability, statistics, ... of finance and business to calculate financial outcomes around Medicare FFS claims and other expenses + Support ...pay, health insurance, 401K and stock purchase plans, tuition reimbursement , paid time off plus holidays, and a flexible… more
- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... environment independently and with cross functional groups.Knowledge of ACA, Medicare , Medicaid, MCO, TPA business requirements preferred.Experience with healthcare… more
- BlueCross BlueShield of North Carolina (NC)
- …of degree, 7+ years of experience in related field **Bonus Points** + Deep Medicare and/or Medicare Advantage regulatory experience + Extensive Medicare / ... plus adoption and surrogacy assistance + Career development programs and tuition reimbursement for continued education + 401k match including an annual company… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... to ensure organizational goals are met and propose opportunities in accurate reimbursement based on the CMS-HCC (Hierarchical Condition Code) model. Perform data… more
- OhioHealth (Columbus, OH)
- …for third-party inquires. * This position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching ... position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for...cost reporting 4 - 6 years as a Sr. Reimbursement Analyst or similar position(s). **Work Shift:**… more
- University of Southern California (Los Angeles, CA)
- This Senior Analyst of Government Reimbursement at Keck Medicine of USC position will support governmental reporting and reimbursement , focusing on tasks ... revenue cycle, compliance, and clinical teams to maintain proper reimbursement under government program rules. This analyst ...the Manager as needed. + Monitor and interpret CMS, Medicare , and Medicaid reimbursement , including proposed and… more
- Commonwealth Care Alliance (Boston, MA)
- …Experience (nice to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred. **Required Knowledge, ... to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements… more
- BayCare Health System (Clearwater, FL)
- …dignity, respect, responsibility and clinical excellence. **Responsibilities:** + The Senior Reimbursement Analyst will work independently within their area of ... working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Senior Reimbursement Analyst - Cost Reporting **Location** Clearwater |… more
- Sanford Health (Fargo, ND)
- …Hours:** 40.00 **Salary Range:** $31.00 - $49.50 **Job Summary** The Lead Reimbursement Analyst provides critical analytical and reimbursement related ... regarding reimbursement functions. Directs the implementation and monitoring of reimbursement functions, which includes Medicare , Medicaid or other third… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Reimbursement Analyst (CCS or CPC) Coding Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid** The Reimbursement ... in accordance with established fee schedules and ensures compliance with Medicare and other insurance carrier guidelines. **Qualifications** + Associate?s degree in… more
- St. Luke's Health System (Boise, ID)
- …reducing costs through data-driven insights and actionable analytics. The Network Reimbursement Analyst is responsible for developing, maintaining, and updating ... SLHP's fee schedule, pricing updates, and reimbursement policy execution. The role evaluates Medicare ...and reimbursement policy execution. The role evaluates Medicare and industry changes, translates coding and regulatory updates… more
- Molina Healthcare (Atlanta, GA)
- …**Job Duties** + Research, review, and decipher state-specific Medicaid and Medicare reimbursement methodologies for providers, including hospitals and ... **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and… more
- UCLA Health (Los Angeles, CA)
- …the financial and operational effectiveness of UC Hospitals. Elevate your expertise in Medicare and Medi-Cal reimbursement while making a meaningful impact on ... degree preferred). + At least five years of experience in healthcare reimbursement or financial analysis, particularly with Medicare and Medi-Cal regulations.… more
- Medtronic (FL)
- …Policy, and Reimbursement (HEPR) team is currently looking for a Reimbursement Analyst who will partner with healthcare providers/decision makers, payers, ... not limited to:** + Works closely with the Health Economics, Policy, and Reimbursement staff to identify/solve coding, coverage or payment issues and provide support… more
- Humana (Little Rock, AR)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will ... System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and… more
- CareFirst (Baltimore, MD)
- …in DC Medicaid reimbursement . + Knowledge of Maryland Mediciad and Medicare reimbursement . + Excellent verbal and written communication skills. + Excellent ... fee schedules for plans that utilize the DC Medicaid reimbursement schedules and methodologies. This position may request to...may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This may also… more
- CareFirst (Baltimore, MD)
- …in DC Medicaid reimbursement . + Knowledge of Maryland Medicaid and Medicare reimbursement . + Excellent verbal and written communication skills. + Excellent ... fee schedules for plans that utilize the DC Medicaid reimbursement schedules and methodologies. This position may request to...may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This may also… more
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