- Baptist Memorial (Memphis, TN)
- …regarding payor financial arrangements. + Research and understand Medicare, Medicaid , and commercial payment methodologies and industry developments. + ... Summary Insures payor contracts are up-to-date in Epic so that expected payment amounts calculates correctly. Provides analytical support related to reimbursement to… more
- Humana (Nashville, TN)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looks for long term improvements of encounter submission processes. Understands… more
- Humana (Nashville, TN)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looking for long-term improvements of encounter submission processes. Begins to… more
- Covenant Health Inc. (Knoxville, TN)
- …to root cause and resolution of denials for corrective action. Work involves research and analysis of revenue cycle projects for Covenant Health entities as they ... with payor rules and claim billing rules. + Performs research and analysis of denials related to charges, CPT...Quality + Coordinates with appropriate parties the complete/ partial payment or repayment of the claims as findings are… more
- Humana (Nashville, TN)
- …This is a cross-functional role bridging technical safety research , systems engineering, governance, and product implementation. **Key responsibilities** ... responsible scaling and deployment + Contribute to and publish novel research on alignment of LLM-based agents, multi-agent cooperation/conflict, or value learning… more