- Humana (Lansing, MI)
- …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 (Lansing, MI)
- …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
- AmeriHealth Caritas (Southfield, MI)
- …partnership with & incentives for providers. + Ensure strategic alignment with state Medicaid agenda and compliance with provider related aspects of state ... preferred. + 10 or more years of experience years of managed care provider contracting and reimbursement experience, including in-depth knowledge of … more
- Molina Healthcare (Cadillac, MI)
- …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
- Humana (Lansing, MI)
- …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 (Warren, MI)
- …experience in Managed Care + 5 or more years hospital reimbursement methodologies + Background in provider contracts, pricing configuration, claim ... The Lead Analyst, Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. Supports existing lines… more
- Cognizant (Lansing, MI)
- We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United ... Monday to Friday - Eastern Time **About the role:** Asan AR Physician Hospital Billing Follow Up, you will be responsible for resolving aged hospital… more
- Guidehouse (Detroit, MI)
- …and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. **This position is 100% ... for charge reconciliation audits + Escalate departments noncompliant with policy and provide action plan when needed + Responsible for the daily resolution of… more
- Banner Health (MI)
- …as necessary. 4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues ... across all groups of patients and all types of provider specialties, as well as the full cycle of...billing is ideal and knowledge of Medicare, Medicare Advantage, Medicaid , and Commercial insurance is highly preferred. **Location** :… more
- Molina Healthcare (Sterling Heights, MI)
- …and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and ... **JOB DUTIES** + Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to… more