- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
- Humana (Columbus, OH)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG,… more
- Humana (Columbus, OH)
- … Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated Pricing ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
- Deloitte (Columbus, OH)
- …consulting services to public sector clients + Support engagements focused on Medicaid reimbursement , including actuarial rate development across managed care ... and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, etc.) + Experience with… more
- Elevance Health (Columbus, OH)
- … Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... sales. The MarketPoint Strategy Advancement team is searching for a Senior Strategy Advancement Professional focused on continuous improvement and optimization… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... to put those customers at the center of everything it does. The Senior Business Intelligence Engineer solves complex business problems and issues using data from… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
- Cardinal Health (Columbus, OH)
- …preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid preferred + Experience with computerized billing software ... requirements and accounts assigned + Works closely with insurance carriers for reimbursement requirements to ensure payment + Reviews outstanding AR accounts and… more
- Centene Corporation (Columbus, OH)
- … Medicaid . + Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. + ... President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies...the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike. This person also will be… more
- Baylor Scott & White Health (Columbus, OH)
- …and senior medical staff including denials from all payers, Medicare / Medicaid audit activities and key contract enforcement activities. + Collaborates ... to improve appeal success rates, ensure regulatory compliance and optimize reimbursement outcomes. Will lead external resources through vendor or contractor… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... help lead the data governance efforts within Humana, partnering closely with the senior leadership and partnering with a strong data governance team + Scale delivery… more
- OhioHealth (Marion, OH)
- …audits ie, , Office of the Inspector General, The Joint Commission, Center for Medicare & Medicaid Services, Internal Revenue Service, etc. This position will ... other key stakeholders. Assist in analysis and coordination of amendments, reimbursement , and contractual language changes. Interacts closley with executive team and… more
- Cardinal Health (Columbus, OH)
- …preferred. + Strong understanding of medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare , Medicaid ). + Proven ... recommend and implement preventive measures. + Prepare and present reports to senior leadership on collection performance, trends, and areas for improvement. +… more