- Novo Nordisk Inc. (Louisville, KY)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... promotion strategies May develop and utilize relationships with specialists, key hospital decision-makers, and other individuals who make or influence the… more
- Humana (Frankfort, KY)
- …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 (Frankfort, KY)
- …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... diverse scope and complexity ranging from moderate to substantial. The Provider Contracting Executive communicates contract terms, payment structures, and … more
- Molina Healthcare (Louisville, 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
- Cognizant (Frankfort, KY)
- We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United ... Monday to Friday - Eastern Time **About the role:** Asan AR Physician Hospital Billing Follow Up, you will be responsible for resolving aged hospital… more
- CenterWell (Frankfort, KY)
- …experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + ... degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or... Experience a plus + Current nursing experience in Hospital , SNF, LTAC, DME or Home Health. + Bilingual… more
- Molina Healthcare (Louisville, 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
- Waystar (Louisville, KY)
- …of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare ... Integrity products + Ability to interpret regulatory guidelines from CMS, Tricare, and Medicaid websites + Ability to understand the vocabulary used in hospital … more
- Molina Healthcare (Louisville, 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 (Louisville, 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 (Louisville, 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
- Novo Nordisk (Louisville, KY)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... strategies + May develop and utilize relationships with specialists, key hospital decision-makers, and other individuals who make or influence the purchasing,… more
