- Elevance Health (Nashville, TN)
- … 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
- Prime Therapeutics (Nashville, TN)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** Manages the ... coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership...not limited to premium amounts, late enrollment penalties, and reimbursement of drug claims. + Ensures the accuracy of… more
- Humana (Maryville, TN)
- …caring community and help us put health first** Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ... the community we serve through face-to-face, telephonic, virtual interactions. Our Medicare Sales Representatives sell individual health plan products and educate… more
- CVS Health (Nashville, TN)
- …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 (TN)
- …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
- AccentCare, Inc. (Franklin, TN)
- …Skilled in problem-solving, understanding referral patterns, and navigating or learning Medicare regulations and hospice reimbursement practices. Proficient with ... Microsoft Office Suite; available for after-hours and weekend referrals as needed. Physically capable of frequent standing, walking, typing, and working on hard/rough surfaces; occasional lifting, kneeling, reaching, and exposure to chemicals, dust, extreme… more
- HCA Healthcare (Brentwood, TN)
- …like you to be a part of our team. **Job Summary and Qualifications** As Reimbursement Manager, you will complete Medicare and Medicaid cost reports to obtain ... join an organization that invests in you as a Reimbursement Manager? At HCA Healthcare, you come first. HCA...policies and procedures. Your responsibilities will include: + Prepare Medicare and Medicaid cost reports to obtain all amounts… more
- Humana (Nashville, TN)
- …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 (Nashville, TN)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and pharmacy… more
- Covenant Health Inc. (Knoxville, TN)
- …rheumatology, sleep medicine and urology. Position Summary: Demonstrates knowledge of Medicare and payer billing guidelines and policies. Demonstrates ability to ... promptly review, interpret and communicate current and changes to published Medicare and other payer billing guidelines/policies. The Billing Liaison must be able to… more