- Humana (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and ... responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to… more
- Molina Healthcare (Bowling Green, KY)
- …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 (Bowling Green, KY)
- …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
- Ascension Health (Nashville, TN)
- …Pharmacy Services IP + **Schedule:** Full-time, 7on / 7off, night shift + ** Hospital :** Ascension Saint Thomas West + **Location:** Nashville, TN Must have ... hospital experience **Benefits** Paid time off (PTO) Various health...assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community _Benefit… more
- HCA Healthcare (Nashville, TN)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our...Analyst works closely with the Payer Analysis Manager to provide financial analysis and operational support for Payment Compliance… more
- Molina Healthcare (Bowling Green, KY)
- …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 (Bowling Green, KY)
- …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 (Bowling Green, KY)
- …(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
- Ascension Health (Nashville, TN)
- …Services + **Schedule:** Full-time, Day Shift, 40 hours per week + ** Hospital :** Ascension Saint Thomas West + **Location:** Nashville, TN + Coordinates clinical ... of Organ Sharing (UNOS) and Centers for Medicare and Medicaid Services (CMS). + Collects and maintains time study...assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community _Benefit… more
- HCA Healthcare (Nashville, TN)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the… more
- HCA Healthcare (Nashville, TN)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... for our team to ensure that we continue to provide all patients with high quality, efficient care. Did...complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are… more
- Humana (Nashville, TN)
- …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