- Humana (Austin, TX)
- …The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG, ... Business Intelligence Engineer will be responsible for: + Researching state-specific Medicaid reimbursement methodologies for hospitals and facilities +… more
- Commonwealth Care Alliance (Boston, MA)
- …responsible for the end-to-end review, analysis, and resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. ... Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and provider… more
- Zelis (Plano, TX)
- …business administration, or a related field + Five+ years of experience in Medicaid billing, reimbursement , claim payment or cost reporting. + Experience with ... the personal interests that shape who you are. Position Overview The Sr. Medicaid Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer Product… more
- RWJBarnabas Health (Oceanport, NJ)
- …as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment strategies across all ... and evaluate changes in reimbursement regulations and policies to optimize reimbursement opportunities + Monitor Medicare and Medicaid appeal and cost report… more
- AdventHealth (Altamonte Springs, FL)
- …proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a ... the team:** + Serve as AHS subject matter resource for Medicare and Medicaid reimbursement matters + Maintain a strong working knowledge of current laws and… more
- UTMB Health (Galveston, TX)
- …for technical aspects, calculations and analyses of multiple areas of Medicare and Medicaid reimbursement components including, but not limited to, cost report ... business or related field plus eight (8) years of Medicare and Medicaid reimbursement experience to include four (4) years of reimbursement supervisory… more
- Commonwealth Care Alliance (Boston, MA)
- …necessary on all new CPT and HCPCS codes for coding logic, related Medicare/ Medicaid policies to make recommend reimbursement determinations. + Analyze, measure, ... operations, health care reimbursement , public health care programs and reimbursement methodologies ( Medicaid and Medicare) + Medical Coding, Compliance,… more
- CareFirst (Baltimore, MD)
- …for preparing and maintaining fee schedules for plans that utilize the DC Medicaid reimbursement schedules and methodologies. This position may request to extend ... degree. **Knowledge, Skills and Abilities (KSAs)** + Detailed expertise in DC Medicaid reimbursement . + Knowledge of Maryland Medicaid and Medicare … more
- CareFirst (Baltimore, MD)
- …for preparing and maintaining fee schedules for plans that utilize the DC Medicaid reimbursement schedules and methodologies. This position may request to extend ... **Knowledge, Skills and Abilities (KSAs)** + Detailed expertise in DC Medicaid reimbursement . + Knowledge of Maryland Mediciad and Medicare reimbursement .… more
- Gilead Sciences, Inc. (Foster City, CA)
- …with an advanced degree (MS, MA, MBA). + Deep knowledge of Medicare and Medicaid reimbursement systems, including Medicaid drug rebate policy, Medicare ... and help create possible, together. **Job Description** **Overview** Director of Reimbursement Policy plays an important role within Gilead's matrixed Policy team… more