• Medicaid Provider Hospital

    Humana (Columbus, OH)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Qualifications** + Experience with Ohio Medicaid hospital reimbursement methodologies + Experience researching and resolving provider reimbursement more
    Humana (04/30/25)
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  • Provider Contracts Manager

    Molina Healthcare (Cleveland, OH)
    …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
    Molina Healthcare (04/04/25)
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  • Manager, Value-Based Provider Contracts

    Molina Healthcare (Cincinnati, OH)
    …contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting, ... etc. * Working experience with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business,… more
    Molina Healthcare (04/16/25)
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  • Provider Contracting Executive

    Humana (Columbus, OH)
    …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to… more
    Humana (05/07/25)
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  • Reimbursement Analyst - System Wide

    Bon Secours Mercy Health (Cincinnati, OH)
    …responsible for providing critical analytical and reimbursement support for reimbursement functions including Medicare, Medicaid , or other third party cost ... health system or other relevant accounting/finance experience + Ability to research reimbursement or net revenue issues and provide practical interpretations and… more
    Bon Secours Mercy Health (05/08/25)
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  • Registered Nurse (RN) - Admissions Coordinator…

    Bon Secours Mercy Health (Lorain, OH)
    …eligibility for care; understand and communicates Center for Medicare & Medicaid Services (CMS) medical necessity and admission criteria. Establishes rapport with ... hospital staff and physicians; serves as consultant/resource person for...(ELOS) appropriately (using insurance and industry guidelines). Qualified to provide thorough and detail-oriented assessment of patient needs and… more
    Bon Secours Mercy Health (02/18/25)
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  • Compliance Auditor - Enterprise Risk

    Bon Secours Mercy Health (Cincinnati, OH)
    …an employee/manager required. + Demonstrated working knowledge of Medicare and Medicaid , Insurance Managed Care including documentation, coding, reimbursement ... Mercy Health's overall compliance audit and compliance responsibilities relative to hospital revenue cycle services performed for Bon Secours Mercy Health. *Please… more
    Bon Secours Mercy Health (05/07/25)
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  • Outreach Registrar, Lab Outreach

    Trinity Health (Columbus, OH)
    …environment and provide first class service + Communicates with other hospital departments and/or physicians practice to obtain, provide or revise ... for information to other areas of the laboratory, as well as other hospital departments and physician practices. Interacts respectfully with other hospital more
    Trinity Health (05/08/25)
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  • Safety Quality Patient Experience Specialist II

    Cleveland Clinic (Mayfield Heights, OH)
    …in working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys ... in working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys… more
    Cleveland Clinic (05/08/25)
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  • Patient Financial Specialist I - New Albany Front…

    Trinity Health (New Albany, OH)
    …Primary job responsibilities include: -Answering phone calls -Welcoming patient and visitors - Provide wayfinding for hospital patients and guests Secondary job ... ICD-9 coding to ensure compliance with third party regulations. Understands Medicare, Medicaid and other third party information requirements and adheres to all… more
    Trinity Health (04/30/25)
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