- Molina Healthcare (KY)
- …standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/ billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts ... and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. * Understanding of… more
- Option Care Health (Frankfort, KY)
- …expected to lead the collaboration with Revenue Cycle Management to ensure billing requirements are contracted appropriately and timely resolutions are achieved with ... outstanding Accounts Receivable. This role has direct supervisory experience for Contract Managers. **Job Description:** **Job Responsibilities** + Leads the Contracting Process and acts as Lead Negotiator for all Targeted Accounts within the defined area.… more
- CareFirst (Reston, VA)
- …business processes supported by the department (eg, claims processing, enrollment and billing , financial, etc.). + Experience in industry best practices for project ... management (including resource estimating, tracking, and metrics), business/systems analysis, and software testing. Demonstrated competence with full software development project life cycle. + Must be able to evaluate demands on a timely basis and distribute… more
- Molina Healthcare (Milwaukee, WI)
- …standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/ billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts ... and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. * Understanding of… more
- CDPHP (Latham, NY)
- …+ Chronic Conditions knowledge preferred. + Experience in claims adjudication, billing and enrollment systems, product or pricing is preferred. + Experience ... with Microsoft Office, including Word, Excel, Outlook and PowerPoint is required. + Experience with Clinical Documentation Improvement preferred. + Demonstrated knowledge of medical record review and diagnosis coding within the health insurance industry. +… more
- Teleperformance USA (MI)
- …first level representatives on high level issues.** + **Assist policy holders with billing questions and concerns** + **Provide support to policy holders with any ... policy changes requested** **Support policy holders needs by providing recommendations and adjusting as necessary** **We're looking for** **fearless people - people who are inspired to deliver only the best in all that we do.** **Qualifications:** + **High… more
- The Cigna Group (Jefferson City, MO)
- …+ Enrollment solutions: Internal capabilities and external options + Administrative solutions: Billing and claim processes The NSD role is responsible for proactive ... and consultative outreach designed to increase the institutional knowledge of Cigna Supplemental Health Solutions in the large case segment. The NSD partners with internal colleagues in distribution, marketing, product, compliance, underwriting, and other… more
- Molina Healthcare (Cincinnati, OH)
- …coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete ... the contract profile. * Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. * Participates in other contracting related special projects as… more
- Huron Consulting Group (Van Buren, AR)
- …Management** + **Compliance Reporting** + **Cost Allocation** + **Sponsor Billing ** + Bachelor's degree in Information Technology, Business Administration, or ... a related field. + Minimum of 6 years of experience in Oracle services or similar roles. + Good knowledge of Oracle ERP modules and functionalities, with at least one certification (level 2 support). + Strong problem-solving and analytical skills. + Excellent… more
- Trinity Health (Livonia, MI)
- …+ Develops reports from supported systems for the purposes of external billing , technical risk mitigation and responsible consumption of system resources by ... customers. + Monitors system resource utilization and takes action to remedy irresponsible consumption of system resources by customers. + Schedules and performs structured and ad hoc training of physician, technologist and other end-users with minimal to no… more