- Humana (Trenton, NJ)
- …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
- Cardinal Health (Trenton, NJ)
- …audit methodology, principles and techniques; CMS manuals; professional and/or hospital services reimbursement and repayment; confidentiality standards. + ... organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and correction of documentation,… more
- Humana (Trenton, NJ)
- …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
- AmeriHealth Caritas (Philadelphia, PA)
- …+ Work with PBM to identify and resolve any operational issues. + Provide support and attend all pharmacy-related meetings and committees sponsored by the line ... participate on the plans' P&T Committee. + Generate necessary provider and member communications related to the pharmacy program....evaluate their effect on pharmacy contracts and services. + Provide on-site education and training for the line of… more
- Humana (Trenton, NJ)
- …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
- Genesis Healthcare (Huntingdon Valley, PA)
- Overview **ABOUT GENESIS** As the nation's leading provider of healthcare services from short-term to long-term and a wide variety of living options and professional ... you comfortable working cross-functionally with departments like **Admissions, Clinical Reimbursement , and Social Services** to maintain accurate and compliant… more