- AdventHealth (Maitland, FL)
- …**Responsible for ensuring the providers are loaded timely and accurately with Managed Care contracted payers. Responsible for evaluating professional fee ... the Physician Enterprise (PE) and works closely with practice office operations staff, Managed Care (MC) contracting, MC Credentialing and Enrollment and billing… more
- Molina Healthcare (Orlando, FL)
- …Experience with Medicaid contract analytics is highly preferred. + Experience working on Managed care analytics and healthcare reimbursement models is ... required. + Must be able to work in a cross functional team. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Finance, Economics, Computer Science **Required Experience** + 6+ years of progressive responsibilities in Data, Finance or Systems… more
- Molina Healthcare (Orlando, FL)
- …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + 5 - 10 years' experience in Managed Care + 5 or more years hospital reimbursement methodologies + Background in ... **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and… more
- AdventHealth (Maitland, FL)
- … Care and role related functions such as new government regulations and reimbursement methodologies. Supports AH Managed Care and AH Regional PFS ... government and non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference to technical system and application… more
- AdventHealth (Maitland, FL)
- …(Medicare, Medicaid, Tricare) payer reimbursement language and methodologies. The Senior Compliance Analyst works with Managed Care staff in all AH ... applicable rules, regulations, policies, laws, and guidelines that impact healthcare billing. ** Reimbursement -30%** + Supports Managed Care leadership in… more
- AdventHealth (Maitland, FL)
- …for analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement . The role focuses on ... ethic, trainability, communicative, team player, and strong analytical skills The Senior Medical Economics Analyst will work with managed care staff for both… more
- Molina Healthcare (Orlando, FL)
- …process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations ... Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan...concept to execution, especially in the areas of provider reimbursement and claims payment integrity. + Strong working knowledge… more
- Molina Healthcare (Orlando, FL)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... Qualifications** + At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent… more
- Molina Healthcare (Orlando, FL)
- …Qualifications** + At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent ... and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more