- 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)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... years of experience in negotiating managed care contracts with physician specialty, hospital and/or other provider contracts. + Proficiency in analyzing,… more
- Molina Healthcare (Chandler, AZ)
- …when providers have issues or complaints (eg claims and encounter data, eligibility, reimbursement , and provider website). * Serves as a resource to support ... government-sponsored health plans. * Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare… more
- Molina Healthcare (Chandler, AZ)
- …care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters ... **Job Description** **Job Summary** Molina's Provider Contracting function provides guidance, signature support services,...providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and… more
- Molina Healthcare (Chandler, AZ)
- …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes * Provides data driven analytics to finance, ... (UB04/1500 form). * Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS… more
- Option Care Health (Phoenix, AZ)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Centene Corporation (Phoenix, AZ)
- …outcome-based reimbursement models + Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication + Initiate ... experience. 2+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician's office or group setting.… more
- Molina Healthcare (Chandler, 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
- Humana (Phoenix, AZ)
- …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
- Banner Health (Phoenix, AZ)
- …Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and ... of service collections and obtains authorizations and forms needed to maximize reimbursement . Document all facets of the registration process and meet accuracy goals… more
- Banner Health (Mesa, AZ)
- …Archival Communication System (PACS) technology - Relocation assistance - Tuition reimbursement - Continuing education programs - Career growth and promotion ... may validate and/or obtain authorizations from payers in order to maximize reimbursement . Provides a customer-oriented interaction with each patient in order to… more
- Molina Healthcare (Chandler, 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 (Chandler, 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 (Chandler, 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