- Humana (Des Moines, IA)
- …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 (Des Moines, IA)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Humana (Des Moines, IA)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... years of experience in negotiating managed care contracts with physician specialty, hospital and/or other provider contracts. + Proficiency in analyzing,… more
- Molina Healthcare (Des Moines, IA)
- …when providers have issues or complaints (eg claims and encounter data, eligibility, reimbursement , and provider website). * Serves as a resource to support ... government-sponsored health plans. * Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare… more
- Humana (Des Moines, IA)
- …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to… more
- Molina Healthcare (Des Moines, IA)
- …care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters ... **Job Description** **Job Summary** Molina's Provider Contracting function provides guidance, signature support services,...providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and… more
- Avera (Des Moines, IA)
- …Report Reimbursement Manager will be responsible for the oversight of reimbursement associated with the Medicare, Medicaid , Tricare and any other ... healths, hopices, and nursing homes. Oversight includes the Medicare, Medicaid and Tricare cost reports for all entities in...clinics, nursing homes and other patient operating units. + Provide expertise, guidance, and advice to the rural network… more
- Molina Healthcare (Des Moines, IA)
- …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes * Provides data driven analytics to finance, ... (UB04/1500 form). * Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS… more
- UnityPoint Health (Des Moines, IA)
- …and across the continuum of care to develop and implement a plan to provide coordinated care to improve outcomes for our transplant patients. The financial navigator ... may be available based on the patient's individual situation. Determines Medicaid , Marketplace, other Community Resources, or UPH Financial Assistance Program as… more
- Molina Healthcare (Des Moines, IA)
- …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
- Humana (Des Moines, IA)
- …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
- Trinity Health (Des Moines, IA)
- …Access or Patient Accounting for hospital registration and / or hospital reimbursement services Obtain National certification in HFMA CRCR and/or NAHAM ... on patient accounts and works with patients or their representatives to provide financial assistance or secure payment. Note: "patients" refers to patients, clients,… more
- Molina Healthcare (Des Moines, IA)
- …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 (Des Moines, IA)
- …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 (Des Moines, IA)
- …(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
- UnityPoint Health (West Des Moines, IA)
- …to learn and level of comprehension. . Consults appropriate resources within the hospital to provide specialized education. . Demonstrates knowledge that patient ... Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance...providing appropriate teaching and making the necessary referrals to provide continuity of care. . Develops an individual plan… more
- UnityPoint Health (West Des Moines, IA)
- …to learn and level of comprehension. . Consults appropriate resources within the hospital to provide specialized education. . Demonstrates knowledge that patient ... Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance...providing appropriate teaching, and making the necessary referrals to provide continuity of care. . Assists the physician with… more
- UnityPoint Health (West Des Moines, IA)
- …four-legged family members. + Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow ... requirements within the designated time frame. + Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (eg… more