- 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 (Wethersfield, CT)
- …healthcare or long-term care industry + Strong understanding of billing and reimbursement processes, including Medicare, Medicaid , and third-party payers + ... * Work SWOTs both on and off site to provide insight to the facility regarding their AR *...40 premier providers of short-term rehabilitation, skilled nursing, and post- hospital care including several named "Best Of" by US… more
- National Health Care Associates (Stafford Springs, CT)
- …for developing personalized resident care plans and the capture of clinical reimbursement for services provided. You will ensure the highest level of revenue ... looking for potential risks and/or changes that may affect reimbursement + May train, mentor and/or manage MDS Coordinators,...teams to ensure accurate data collection for assessments + Provide insights and ongoing education to facility staff 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
- Humana (Hartford, CT)
- …2 who initiates, negotiates, and executes physician, hospital , and other provider contracts and agreements related to Medicaid health plans. The ... and independent determination of the appropriate courses of action. The Provider Contracting Professional 2 responsibilities include (but not limited to): +… more
- Humana (Hartford, CT)
- …executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and ... responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to… 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
- Humana (Hartford, CT)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy… 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
- Hartford HealthCare (Farmington, 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
