- Humana (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Humana (Phoenix, AZ)
- …2 who initiates, negotiates, and executes physician, hospital , and other provider contracts and agreements related to Medicaid health plans. The ... and independent determination of the appropriate courses of action. The Provider Contracting Professional 2 responsibilities include (but not limited to): +… more
- Humana (Phoenix, AZ)
- … Contracting Professional helps ensure network adequacy, competitive reimbursement structures, and compliance with regulatory requirements. Through effective ... part of our caring community and help us put health first** The Senior Provider Contracting Professional serves as a primary point of contact for Humana's … more
- Molina Healthcare (Phoenix, AZ)
- …experience in Managed Care + 5 or more years hospital reimbursement methodologies + Background in provider contracts, pricing configuration, claim ... The Lead Analyst, Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. Supports existing lines… more
- Molina Healthcare (Phoenix, AZ)
- …and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and ... **JOB DUTIES** + Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to… more
- Banner Health (Phoenix, AZ)
- …**Patient Financial Service Representative** , you will have the opportunity to provide direct support to our patients assisting with registering patients, verifying ... Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and… more
- Molina Healthcare (Phoenix, AZ)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Phoenix, AZ)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Phoenix, AZ)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- CommonSpirit Health (Phoenix, AZ)
- …such as Medicaid and Medicare + Working knowledge of various reimbursement methodologies including DRG's, per diems, RVU's + Ability to effectively work within ... complex payer information and reports are analyzed and summarized to provide timely operationaland contracting recommendations for key internal leaders. Research… more
- Humana (Phoenix, AZ)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy… more