- Houston Methodist (Houston, TX)
- …managed care payers include commercial payers, separate transplant contracts, Medicare Advantage, Medicaid Health Maintenance Organizations (HMOs), ... outs, new procedures, new drugs. Analyzes proposals which include capitation reimbursement , Medicare resource-based revenue value scale (RBRVS) values, current… more
- Houston Methodist (Nassau Bay, TX)
- …by capacity to prioritize multiple tasks and role components + Knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... are medically necessary and communicates clinical information to payors to ensure reimbursement . The CM PRN helps drive change by identifying areas where performance… 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 ... standard and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid (CMS), and AHIMA for assignment of diagnostic and… more
- HCA Healthcare (Tampa, FL)
- …and communicate nuances of unique coding requirements for major payers such as Medicare , Medicaid , HMO's, PPO's, IPA's, employers, etc. + Demonstrate and share ... to improve the accuracy, consistency, and efficiency of code assignment for reimbursement and reporting purposes. This individual will assist in training and support… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …lieu of a degree. **Preferred Qualifications and Skills:** 1. Knowledgeable with Medicare and Medicaid quarterly releases and other Government Payers. ... **Description** The **Contract Implementation Analyst - Reimbursement ** reduces the volume of requests forwarded to the IT Analysts by defining specific Epic and… more
- BayCare Health System (Clearwater, FL)
- …the Team:** + Analyze government reimbursement data and develop strategies for Medicare / Medicaid Cost Reports + Prepare and review annual cost reports and ... **Position Details:** Clearwater, FL (Hybrid) | Full-Time | Exempt | Reimbursement Department **About the Role:** The Senior Revenue Management Analyst plays… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... MSHS Health System. This individual will ensure the accuracy of contract terms, reimbursement structures, and facilitate the flow of contract data into the revenue… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and audits utilizing knowledge and experience of ICD-9-CM/ICD-10-CM coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding, and ... Medicaid Clinical Risk Groups (CRGs) to ensure compliance. *...by leadership. * Maintains accuracy in all coding and reimbursement methods by researching literature and attending professional seminars,… more
- Humana (Springfield, IL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... referrals). + Work with internal resources and systems (eg, claims, reimbursement , provider enrollment) to provide Exceptional Experience in all provider… more
- Covenant Health Inc. (Knoxville, TN)
- …+ Demonstrates knowledge of State and Federal regulations, HCFA guidelines, HIPAA, Medicare / Medicaid guidelines and other Third Party Payor requirements assuring ... provides training for new or revised rules ensuring compliance with HCFA Tenncare/ Medicaid or other State or Federal regulations. + Resolves complex collection… more