- Elevance Health (Louisville, KY)
- … and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with ... Reimbursement Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement . This position provides a… more
- CVS Health (Frankfort, KY)
- …participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The ... Medical Director will act as a business and clinical liaison to network providers and facilities if needed, to support the effective execution of medical services programs by the clinical teams. **Required Qualifications** *Two (2) or more years of experience… more
- Banner Health (KY)
- …Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group ... clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work… more
- J&J Family of Companies (Lexington, KY)
- …relates to payer approval processes and business acumen. + Understanding of Medicare , Medicaid, and private payer initiatives affecting reimbursement of ... at https://www.jnj.com **Job Function:** Market Access **Job Sub** **Function:** Reimbursement **Job Category:** People Leader **All Job Posting Locations:**… more
- Highmark Health (Frankfort, KY)
- …teams that engage providers enrolled in the Organization's value-based reimbursement programs and continuous improvement models. The incumbent plays different ... of workflows resulting in outstanding performance in the Organization's value-based reimbursement programs ensuring that ROI targets as set by the Organization… more
- Otsuka America Pharmaceutical Inc. (Frankfort, KY)
- **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert on reimbursement , access, and coverage issues for our products, ... Educate HCPs and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria… more
- Humana (Frankfort, KY)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an ... System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and… more
- Cardinal Health (Frankfort, KY)
- …verbal format + Be familiar with long- and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial plans ... Communication + Data Entry Skills + Product Knowledge - Insurance, reimbursement , specialty pharmaceutical + Objectivity + Dependability + Multi-tasking + Maintain… more
- Signature Healthcare (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 Great ... and Controller and requirements set forth by Medicaid and Medicare . How you Will make a difference + Identify...Plan + 401(K) and Roth 401(K) + Tuition Forgiveness/Education Reimbursement + A variety of additional specialized Insurances +… more
- Molina Healthcare (Owensboro, KY)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. + Translates… more