- Humana (Springfield, IL)
- …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 (Springfield, IL)
- …Professional who initiates, negotiates, and executes physician, hospital , and other provider contracts and agreements related to Medicaid health plans. The ... seeking a Provider Contracting...with QuickBase. + 2+ years of network development and Medicaid /Medicare experience. + Excellent written and verbal communication skills.… more
- Intermountain Health (Springfield, IL)
- …to appropriately maximize reimbursement . Interacts with Medicare Administrative Contractor, State Medicaid , and hospital personnel as needed. + Acts as a ... individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as needed. + Prepares monthly Medicare..., and/or governmental reporting + Experience with Medicare and Medicaid reimbursement world and cost reports. +… more
- Morris Hospital (Morris, IL)
- …+ The Accountable Care Organization (ACO) nurse coordinates team based care to provide , develop, implement, and manage programs set by Centers for Medicare & ... Medicaid Services (CMS) and our ACO consortium. These services...be determined by qualifications, experience, and internal equity. Morris Hospital & Healthcare Centers offers a comprehensive benefit package… more
- Humana (Springfield, IL)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... 2 - 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts and/or working with insurance in a… more
- Rush University Medical Center (Chicago, IL)
- …to resolve issues while also analyzing necessary information that will ensure hospital reimbursement . 9. Appropriately informs the patients of hospital ... to resolve issues while also analyzing necessary information that will ensure hospital reimbursement . 13. Maintains a working knowledge of applicable Federal,… more
- Cardinal Health (Springfield, IL)
- …understands the trends that affect current and future healthcare business models and reimbursement to make short and long term strategies. Will serve as an executive ... implements managed care contracting strategy including implementation of value-based reimbursement initiatives. Responsible for maintaining reimbursement strategy… more
- Trinity Health (Maywood, IL)
- … Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement . Utilizes encoder software applications, which includes all ... **Description:** Part-time 32 hours weekly Under direct supervision, reviews physician/ provider documentation in Inpatient health records to determine the principal… more
- Humana (Springfield, IL)
- …to quality review the inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to… more
- SSM Health (Mount Vernon, IL)
- **It's more than a career, it's a calling.** IL-SSM Health Good Samaritan Hospital - Mt. Vernon **Worker Type:** Regular **Pay Range:** $15.00 - $22.15 **Pay Rate ... the posted range as permitted by law. **Job Summary:** Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans.… more