- 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 ... Qualifications** + Experience with Ohio Medicaid hospital reimbursement methodologies + Experience researching and resolving provider reimbursement… more
- Humana (Raleigh, NC)
- …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to… more
- CVS Health (Durham, NC)
- …**Dual Eligible Special Needs Plan** (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. ... face interactions which include visits to member homes, in the community, and/or provider locations. + Care management activities will focus on quality of care,… more
- Humana (Raleigh, NC)
- …to quality review the inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to… more
- PruittHealth (Raleigh, NC)
- …levels of care. 2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 3. ... continuum and facilitating admissions into the Pruitt Health network. 5. Must provide excellent customer service to all referral sources and network of providers.… more