- Baylor Scott & White Health (Frankfort, KY)
- …5 Years of Experience + State Supplemental Payment Program Experience **preferred.** + Medicaid and Medicare Reimbursement Experience **highly preferred** + ... vary based on position type and/or level **Job Summary** The Manager of Reimbursement reviews cost reports for supported entities. Assists Reimbursement Managers… more
- Humana (Frankfort, KY)
- …The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG, ... Business Intelligence Engineer will be responsible for: + Researching state-specific Medicaid reimbursement methodologies for hospitals and facilities +… more
- Humana (Florence, KY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... us put health first** Are you passionate about the Medicare population, looking for an opportunity to work in...Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children + And… more
- Cardinal Health (Frankfort, KY)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, ... preferred + Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and… more
- Signature Healthcare (Owensboro, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified ... Assessment Instrument (RAI), Prospective Payment Systems (PPS), Quality Measures (QM's), Medicaid Casemix and Medicare guidelines for all SHC stakeholders.… more
- CenterWell (Frankfort, KY)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare / Medicaid Experience a plus + Current nursing ... experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity +… more
- Molina Healthcare (Louisville, KY)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... + 5+ years of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work… more
- Cardinal Health (Frankfort, KY)
- …insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare , Medicaid , Managed Care, and ... + High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred… more
- Cognizant (Frankfort, KY)
- …Experience with QNXT COB functionality. + Have worked with QCS. + Familiarity with Medicaid and Medicare programs are minimum requirements, as well as knowing ... when gaps are identified. + Interpret paper contracts for reimbursement + Work side by side with client team...cautionary reduction functionality. + QNXT SMEs with experience in Medicare Benefit. + Experience with items like Cost Share.… more
- Humana (Frankfort, KY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... preferably in the health care or insurance industry, and specifically in Medicare Advantage products + Exceptional leadership and management skills, and the ability… more