- Humana (Oklahoma City, OK)
- …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 (Oklahoma City, OK)
- …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- Humana (Oklahoma City, OK)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
- Humana (Oklahoma City, OK)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... + 2+ years of network management experience including but not limited to: provider and hospital contracting, network administration in a healthcare company or… more
- Cardinal Health (Oklahoma City, OK)
- …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 (Oklahoma City, OK)
- …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
- TEKsystems (Oklahoma City, OK)
- Description JOB SUMMARY Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. PRIMARY RESPONSIBILITIES * ... reverifications as needed (ex; first of the month reverifications for managed Medicaid 's). * Works collaboratively with insurance companies, providers and staff to… more
- Humana (Oklahoma City, OK)
- …ensure medical documentation and coding are precise, compliant, and support optimal reimbursement . This is an exciting opportunity to apply your advanced technical ... Applies clinical and coding experience to conduct reviews of provider codes and billing. + Decisions are typically related...or more years of clinical RN experience in a hospital setting. + 3 or more years of experience… more