- Molina Healthcare (Louisville, KY)
- …expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job Qualifications** **Required… more
- CenterWell (Frankfort, KY)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... as medical, dental and vision benefits, 401k with company matching, tuition reimbursement , 3 weeks paid vacation time, paid holidays, work-life balance, growth, a… more
- NASCO (Frankfort, KY)
- …laws and regulations related to our products and services, including for our Medicare Advantage and ACA Exchanges business + Interacts with vendors and customers on ... on compliance issues, including related to HIPAA + Experience supporting Medicare Advantage and ACA Exchanges business **Required Training, Certification and… more
- Signature Healthcare (Bowling Green, 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 ... family interviews. + Participate in Daily PPS meetings, weekly Medicare meetings, and month end meetings to assure federal...Life/Disability + 401(K) and Roth 401(K) + Tuition Forgiveness/Education Reimbursement + Pay Advance and Next Day Pay! +… more
- Molina Healthcare (KY)
- …providers. Contract/Re-contracting with large scale entities involving custom reimbursement . Executes standardized Alternative Payment Method contracts. Issue ... attorney. * Participates in fee schedule determinations including development of new reimbursement models. Seeks input on new reimbursement models from Corporate… more
- Banner Health (KY)
- …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- CVS Health (Frankfort, KY)
- …and DME claims and invoices to governmental and commercial insurance companies for reimbursement for our patients' insurance claims. In this role, you will ensure ... working with commercial insurance companies and/or governmental payers, including Medicare and Medicaid. **Preferred Qualifications** + Strong attention to detail… more
- Cardinal Health (Frankfort, KY)
- …preferred + Demonstrate effective, empathetic and professional communication + Clear knowledge of Medicare (A, B, C, D) + 1-2 years of Pharmacy and/or Medical Claims ... access to the patient support program resources by compliantly navigating reimbursement , and mitigating any patient out-of-pocket barriers, as applicable +… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Responsible for correctly processing healthcare claims to obtain reimbursement to various third party payers and patients, ensuring proper account documentation in ... such as The Joint Commission, Rural Health, and Center for Medicare Services. ESSENTIAL FUNCTIONS Provides exceptional customer service. Answering and referring… more
- Lundbeck (Corbin, KY)
- …comprehensive therapeutic knowledge to uncover and prioritize unique opportunities. ** Reimbursement ** - Consistently demonstrate the ability to stay informed on ... reimbursement dynamics, anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. **Pharmaceutical… more
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