- Humana (Austin, TX)
- …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
- Molina Healthcare (Fort Worth, TX)
- …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to… more
- Molina Healthcare (Houston, TX)
- …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
- Molina Healthcare (TX)
- …* 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
- Methodist Health System (Dallas, TX)
- …and state laws relating to healthcare, including but not limited to Medicare/ Medicaid reimbursement , HIPAA, AKS, self-referral prohibitions, and fraud and abuse. ... quality of care issues, informed consent, managed care contracting and negotiations, provider credentialing, and billing and reimbursement issues. + The AGC… more
- UTMB Health (Galveston, TX)
- …, and other third-party pay or regulatory requirements. + Thorough knowledge of Hospital reimbursement and managed care contract issues. + Knowledge of automated ... Director of Hospital Accounts Receivable **Galveston, Texas, United States** **New**...the Enterprise on denials trends and opportunities for maximizing reimbursement . + Responsible for the coordination and provision of… more
- Guidehouse (Lewisville, TX)
- …None **What You Will Do** **:** The **Insurance Patient Account Representative - Hospital A/R Emphasis** is an extension of a client's business office staff. ... and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials...Claims + Account Review + Appeals & Denials + Medicare/ Medicaid + Insurance Follow-up + Customer Service + Billing… more
- Genesis Healthcare (TX)
- …through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, ... new NM for easy travel. Within a defined geographic area, the Clinical Reimbursement Lead models the MDS process and capability standards providing direct guidance… more
- Houston Methodist (Houston, TX)
- …of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid , Workers Comp, Commercial plans, etc.; knowledge of how to interpret a ... takes a more participatory role in meetings and negotiations with Insurance Provider Relation and collaborations with third party vendors. The Senior Commercial… more
- Texas Health Resources (Fort Worth, TX)
- …skills. + Entity Finance Officer must have the knowledge of product pricing, provider reimbursement and financial requirements specific to hospitals. + Entity ... Finance Officer must have the ability to anticipate and model what changes in reimbursement will mean for the hospital . Texas Health requires a resume when an… more
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