- Ascendis Pharma (Princeton, NJ)
- …Oversee the administration of rebate programs, including government rebates (eg, Medicaid , Medicare ), managed care rebates, and commercial rebates. Ensure ... models, and contracting strategies across various payer segments (eg, commercial, Medicare , Medicaid ). + Excellent negotiation, communication, and interpersonal… more
- United Therapeutics (IL)
- …Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in ... commercial teams, to develop and implement plans that optimize patient access and reimbursement . You are an expert in therapy access with an understanding of… more
- UPMC (Pittsburgh, PA)
- …clinical coding edits. Your insights will help us ensure compliance with Medicare , Medicaid , and other payor requirements while identifying opportunities for ... passionate about ensuring accuracy and driving efficiency in healthcare reimbursement ? At UPMC Health Plan, we're looking for a...Analyst to play a critical role in shaping how claims are processed and paid. This is your opportunity… more
- LA Care Health Plan (Los Angeles, CA)
- …standards, and best practices. Advanced knowledge of and experience with current Commercial, Medicare , and Medicaid rules and regulations and core systems code ... Core Systems applications, and databases (eg, QNXT Migration Utility, Claims Workflow, Claims Test Pro, NetworX Pricer,...benefits including + Paid Time Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision… more
- Centene Corporation (Jefferson City, MO)
- …and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services. + Ensures Payment Integrity DRG Review ... with coding practices through a comprehensive review and analysis of medical claims , medical records, claims history, state regulations, contractual obligations,… 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
- Gentiva (Mooresville, NC)
- …systems and reimbursement processes. **Key Responsibilities:** + Process assigned Medicare , Medicaid , and/or Commercial claims and payments accurately ... **Overview** **Streamline Claims . Ensure Accuracy. Support Quality Care.** We are...Full-Time Benefits:** + Medical, Dental, Vision Insurance + Mileage Reimbursement or Fleet Vehicle Program + Generous Paid Time… more
- FlexStaff (New York, NY)
- …submit claims to both private and public insurance carriers, including Medicare , Medicaid , and commercial plans. * Investigate and resolve denied or ... extensive experience and strong technical knowledge of medical billing and insurance reimbursement processes to work for our external client, a world leading… more
- CVS Health (Madison, WI)
- …process, pre-certification, and predetermination of covered benefits in the commercial, Medicare , and Medicaid environment. This Wheelchair DME consultant ... alignment and correct application of Aetna policies and practices for commercial, Medicare , and Medicaid environments. ◾Proactively use data analysis to identify… more
- Emory Healthcare/Emory University (Duluth, GA)
- …eligibility, and/or evaluating for financial assistance. + Requires knowledge of Medicare , Medicaid , and Third Party carriers, referrals and pre-certification ... start day 1 + Student Loan Repayment Assistance & Reimbursement Programs + Family-focused benefits + Wellness incentives +...a level appropriate for the job. + Knowledge of Medicare , Medicaid , Third Party carriers, referrals and… more