- CareFirst (Baltimore, MD)
- …(KSAs)** + Understanding of multiple reimbursement methodologies used in healthcare provider contracting , including third party payment methodologies, delegated ... business or related field. + 1 year experience in contracting , provider recruitment or provider ...service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external… more
- The Cigna Group (Salem, OR)
- …anywhere in the USA** **Summary** This role delivers professional activities in the Provider Contracting job family. The position is responsible for dental ... provider recruitment and contracting as well as...provider inquiries, concerns, complaints, appeals and grievances + Provide ongoing product education to dentists and their staff… more
- BayCare Health System (FL)
- …vary) + **Days:** Monday - Friday The Credentialing and Provider Enrollment Specialist Senior will work in a remote role. Responsibilities: + Responsible for ... enrollment activities for BMG providers. + Responsible for tracking a BMG provider 's onboarding from recruitment, contracting , credentialing, provider … more
- Centene Corporation (Nashville, TN)
- …including experience in a managed health care environment with exposure to provider contracting , servicing benefits interpretation, and internal operations of ... well as claims payment resolution as it relates to provider set up. Provide support to external...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- CareFirst (Baltimore, MD)
- …process. Coordinates non-par provider /facility case rate negotiations between Provider Contracting , providers and facilities. Follows member contracts to ... to the medical directors. Collaborates with medical directors, sales and marketing, contracting , provider and member services to determine appropriate benefit… more
- CareFirst (Baltimore, MD)
- …and implemented. Provides expert knowledge to support effective partnership with provider entities and guidance on the appropriate quality measure capture and ... submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for… more
- Cordis (Miami Lakes, FL)
- …who keep saving lives. **Responsibilities** **Job Summary:** The Pricing Contract Sr Specialist is responsible for managing the full lifecycle of complex customer ... and strategic accounts, including GPOs and IDNs. The Senior Specialist proactively identifies opportunities to improve contract performance, supports strategic… more
- Spectrum Billing Solutions (Skokie, IL)
- …skills. RCM Analyst | Revenue Cycle Credentialing Specialist | Insurance Specialist | Revenue Cycle Contracting Specialist | Medical Billing ... skills. This is a remote or hybrid in-office/ remote role. Your Responsibilities: + Complete provider ...with third-party carriers and government health plans. + Review provider credentialing and contracting information to ensure… more
- Molina Healthcare (Mesa, AZ)
- …governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other ... and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials,… more
- Molina Healthcare (Seattle, WA)
- …must live in Washington _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and ... Manager and/or Director in the negotiation of medical group/IPA and hospital contracting . * Advises Network Provider Contract Specialists on negotiation of… more