- Humana (Olympia, WA)
- …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 Developing… more
- Humana (Olympia, WA)
- …Senior Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
- Regeneron Pharmaceuticals (Seattle, WA)
- …and submissions in range of payer environments. Well versed with implementing and executing Medicare , Medicaid , and other payer initiatives. + We expect you to ... **Field Reimbursement Manager (FRM), Ophthalmology - Seattle (PNW)** The...you:** + Previous experience working with billing and medical claims personnel in various health care settings, including, but… more
- Molina Healthcare (Vancouver, WA)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and state regulatory requirements are met ... and executing projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state...* Applies understanding of health care regulations, managed care claims workflows, and provider reimbursement models to… more
- Molina Healthcare (WA)
- …improve financial performance. This role supports Molina's New York Health Plan Medicaid program and its associated reimbursement methodologies. **Essential Job ... and manages information from large data sources. * Analyzes claims and other data sources to identify early signs...performance is achieving desired results. * Keeps abreast of Medicaid and Medicare reforms and impact on… more
- Cardinal Health (Olympia, WA)
- …teams with respect to day-to-day operations, including, without limitation, advice on Medicare and Medicaid DMEPOS supplier billing requirements, local coverage ... Related work experience with Brightree, preferred. + Expert-level knowledge of Medicare and Medicaid billing and documentation requirements; healthcare… more
- Molina Healthcare (Bothell, WA)
- …intervention/communication when providers have issues or complaints (eg, problems with claims and encounter data, eligibility, reimbursement , and provider ... groups of physicians, hospitals, integrated delivery systems, and ancillary providers with Medicaid and/or Medicare products * 5+ years previous managed… more
- Cognizant (Olympia, WA)
- …configuration decisions and downstream impacts. + **Apply comprehensive knowledge of Medicaid , Medicare , and commercial business rules across configuration ... Dental Authorizations, Pre‑Determinations, and Dental Utilization Edits. + **Strong understanding of Medicare , Medicaid , and commercial lines of business** . +… more
- Molina Healthcare (Bellevue, WA)
- …and timely intervention/communication when providers have issues or complaints (eg claims and encounter data, eligibility, reimbursement , and provider website). ... individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid , Medicare , and or Marketplace products, or equivalent… more
- Humana (Olympia, WA)
- …it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more