- Stony Brook University (Commack, NY)
- …support Joint Operating Committee (JOC) meetings, contract settlement discussions, and reimbursement escalations. + Ensure compliance with Medicare and Medicaid ... + Oversee and direct the negotiation, execution, and administration of all hospital , physician, and ancillary Managed Care contracts. + Maintain accurate, up-to-date… more
- AdventHealth (Kissimmee, FL)
- …community you will be caring for:** + AdventHealth Kissimmee is a 242-bed community-focused hospital + Conveniently located near Walt Disney World + The team is here ... of Nursing and is responsible for patient evaluations of post- hospital needs; development of a transition of care plans...remove barriers to timely and efficient care delivery and reimbursement . The RN Care Manager provides education to nurses,… more
- Houston Methodist (Houston, TX)
- …physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital . + Applies approved utilization criteria to ... are medically necessary, communicating clinical information to payors to ensure reimbursement . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates in an active, positive… more
- Stony Brook University (Stony Brook, NY)
- …experience in charge/ reimbursement analysis, maintenance, audit or review for a Hospital Finance or Revenue Cycle Department. + Strong working knowledge of CPT, ... + Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies. + Knowledge of… more
- Houston Methodist (Houston, TX)
- …outs, new procedures, new drugs. Analyzes proposals which include capitation reimbursement , Medicare resource-based revenue value scale (RBRVS) values, current ... maintenance and payer relations of the Houston Methodist (HM) contracts for reimbursement of services billed through managed care companies and serves as a… more
- Banner Health (AR)
- …Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group ... production role but does require coding proficiency and recent Hospital Facility Coding experience.** This position is task-production-oriented ensuring quality… more
- Sharp HealthCare (San Diego, CA)
- …Procedural Coding System (HCPCS) codes to assure appropriate assignment for outpatient Medicare reimbursement .Reviews and verifies charges to assure an accurate ... Association (AHIMA); HS Diploma or Equivalent; Certified Procedural Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC); Registered Health… more
- Amgen (Chicago, IL)
- … committee structure, P&T process, treatment and discharge protocols, DRG and hospital reimbursement process for all assigned accounts and communicates with ... policies + Accountable for ensuring formulary adoption in targeted / assigned hospital accounts to help drive appropriate utilization of approved CV products; works… more
- Amgen (Boston, MA)
- … committee structure, P&T process, treatment and discharge protocols, DRG and hospital reimbursement process for all assigned accounts and communicates with ... policies + Accountable for ensuring formulary adoption in targeted / assigned hospital accounts to help drive appropriate utilization of approved CV products; works… more
- AdventHealth (Minneola, FL)
- …or Manager or Director of Nursing and is responsible for patient evaluations of post- hospital needs; development of a transition of care plans and initiation of the ... intervening to remove barriers to timely and efficient care delivery and reimbursement . The RN Care Manager provides education to nurses, physicians and the… more