- Humana (Boston, MA)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Molina Healthcare (Boston, MA)
- …have issues or complaints (eg, problems with claims and encounter data, eligibility, reimbursement , and provider website). * Serves as a resource to support ... * Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or Medicaid … more
- Beth Israel Lahey Health (Westwood, MA)
- …difference in people's lives.** Under the direction of the Manager, Provider Enrollment completes enrollment and health plan recredentialing applications. Maintains ... resource to providers, practice staff, BIDCO staff and health plan provider representatives concerning health care plan participation and status. Demonstrates… more
- Option Care Health (Boston, MA)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- CenterWell (Boston, MA)
- …experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + ... degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or... Experience a plus + Current nursing experience in Hospital , SNF, LTAC, DME or Home Health. + Bilingual… more
- East Boston Neighborhood Health Center (Revere, MA)
- …financial management and regulatory compliance + Pharmacy/340B program finance + Hospital -based or HLHC billing and reimbursement preferred + Demonstrated ... Deep knowledge of: + FQHC and PACE regulations, 340B program, and Medicaid /Medicare reimbursement + Third-party billing, risk adjustment, and alternative payment… more
- Hologic (Marlborough, MA)
- …in relationship development + Hands-on experience with Medicare Part B reimbursement , hospital outpatient departments and physician office-based reimbursement ... in the United States. This role will be instrumental in optimizing reimbursement pathways, expanding coverage, and ensuring access across various sites of care.… more
- Beth Israel Lahey Health (Wakefield, MA)
- …industry, provider reimbursement methodologies (for a variety of provider types and including Medicaid & Medicare) and risk-based contracting. Experience ... Hospitals, Professional providers, Behavioral Health, Home Care/Hospice). The Manager will provide the overall leadership for the contract language, rate reviews and… more
- Humana (Boston, MA)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more