- Molina Healthcare (Savannah, GA)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (Augusta, GA)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (Macon, GA)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more
- Baylor Scott & White Health (Atlanta, GA)
- …and reporting to stakeholders across all lines of business (Commercial, DTE, Medicare , and Medicaid ). Candidate will oversee extracting and analyzing medical ... and pharmacy claims data, translating output into business recommendations. This individual...plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 Note: Benefits… more
- Molina Healthcare (Columbus, GA)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) * Advanced understanding on health care financial… more
- Trinity Health (Lavonia, GA)
- …Knowledge of insurance and governmental programs, regulations and billing processes ( Medicare , Medicaid , Social Security Disability, Tricare, and Supplemental ... or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service… more
- Centene Corporation (Atlanta, GA)
- …or group setting. Familiarity with State and/or Federal health care programs preferred ( Medicaid , Medicare ). **Candidates must be in the state of Georgia to ... oversee to the provider set-up and contract configuration to ensure accurate claims adjudication + Initiate contact and identify potential providers by geographic… more
- Ascendis Pharma (GA)
- …collaboration with US payers, including both commercial and public payers such as Medicare and Medicaid . + Collaborate with commercial and medical in responding ... RWE and HEOR research activities (including retrospective/prospective research concepts, claims analyses, and economic modeling, etc) to support HEOR objectives.… more
- Grant Thornton (Atlanta, GA)
- …related to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing, billing, and reimbursement , with a focus on ... as the Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS). + Experience with Sarbanes-Oxley Section 404 compliance. +… more