- National Health Care Associates (East Hartford, CT)
- …personalized resident care plans and ensures the capture of clinical reimbursement for services provided. **Key Responsibilities:** + Determine Patient Driven ... prospective residents by assessing their nursing needs and determining appropriate clinical reimbursement levels + Complete and assure the accuracy of the MDS… more
- National Health Care Associates (Bloomfield, CT)
- …including management or supervisory responsibilities + Thorough knowledge of Medicare, Medicaid , Pending, Applied Income, and Managed Care reimbursement ... Your work will ensure regulatory compliance and that resources are optimized to provide the best care for our residents. **Key Responsibilities:** + Efficient and… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …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
- Molina Healthcare (Springfield, MA)
- …have issues or complaints (eg, problems with claims and encounter data, eligibility, reimbursement , and provider website). * Serves as a resource to support ... * Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or Medicaid … more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …highly complex cost, financial analysis functions for calculating Medicaid reimbursement methods. + Experience analyzing claims data, provider financial ... for RHTP. This position is responsible for the development and implementation of Medicaid reimbursement methodologies that support RHTP projects. Proficiency in … more
- Baystate Health (Springfield, MA)
- …are a 716-bed independent academic medical center. We are the community's major referral hospital , and we provide a wide range of services, including: + Cancer ... 4 consecutive times + Named a top 50 cardiovascular hospital by Watson Health **SCHEDULE:** + Full time 40...separation from Baystate Health) + Continuing education support and reimbursement + First Time Home Buyers Financial Packages +… more
- Humana (Hartford, CT)
- …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
- Hartford HealthCare (Newington, CT)
- …reason for underpayments, denials and cause of payment delays.Maximizes insurance reimbursement timely with commercial and governmental payers C. Resolves denials ... Prepares research and documentation in preparation for meetings with provider reps that will assist in resolution of payer...for other ad hoc analyses and projects as needed Provide team support during team vacations and unexpected absence… more
- Molina Healthcare (Springfield, MA)
- …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
- Pfizer (Springfield, MA)
- …decision making roles of all levels at integrated health systems, large hospital systems, health insurance plans, state departments of health, county/city health ... programs. This includes a clear understanding of the commercial, Medicaid and Medicare landscape as it relates to the...to educate colleagues across Pfizer on insights gained. * Provide the marketing and strategy teams with key local… more
- Hartford HealthCare (Newington, CT)
- …accounts receivables engagements with small balance, out of state Medicaid and credit vendors as needed. *_Requirements and Specifications:_* *Education* ... and Ability Requirements** * . Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred . Knowledge of state and federal… more
- Hartford HealthCare (Farmington, CT)
- …of accounts receivables engagements with small balance, out of state Medicaid and credit vendors as needed.** *_Requirements and Specifications:_* **Education** . ... Ability Requirements** ** . Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred . Excellent analytical and problem… more
