- Humana (St. Paul, MN)
- …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 (St. Paul, MN)
- …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 (St. Paul, MN)
- … 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 (St. Paul, MN)
- …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
- Avera (Minneapolis, MN)
- …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
- Cardinal Health (St. Paul, MN)
- …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 (St. Paul, MN)
- …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
- Humana (St. Paul, MN)
- …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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Licensed Professional Clinical Counselor (LPCC) * 1 year of county and/or hospital experience. * Medicaid /Medicare and/or Public Programs experience. * Knowledge ... BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical approaches that will serve and support members...gaps internally or for the member, health plan or provider coverage needs, and raise gaps to leadership as… more
- Grifols Shared Services North America, Inc (Minneapolis, MN)
- …territory including major accounts and large players (ie, Commercial, Medicare, and Medicaid ) *Understanding of Hospital formulary with guidance of RSD and ... to fulfill customer needs and impact pull-through (eg, MSL, IG Nurse Educator, reimbursement specialist) *Gather and provide customer insights to Marketing teams… more
- Philips (Plymouth, MN)
- …Philips Biomed/Clinical Engineering program which includes Centers for Medicare & Medicaid Services (CMS), FDA and accreditation agencies. + Drive new initiatives ... in an office/home office and/or remote setting, as well as in a hospital /healthcare environment; adhere to requirements. + Work flexible hours (based on business… more