- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
- Humana (Columbus, OH)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG,… more
- Deloitte (Columbus, OH)
- …consulting services to public sector clients + Support engagements focused on Medicaid reimbursement , including actuarial rate development across managed care ... and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, etc.) + Experience with… more
- Elevance Health (Columbus, OH)
- … Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare… more
- Humana (Columbus, OH)
- …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Molina Healthcare (Columbus, OH)
- …if financial and clinical performance is achieving desired results. * Keeps abreast of Medicaid and Medicare reforms and impact on the Molina business. * ... JOB DESCRIPTION Job Summary Provides senior level analyst support for medical economics analysis...care management or related field. * Demonstrated understanding of Medicaid and Medicare programs or other health… more
- CVS Health (Columbus, OH)
- …speed to market and to support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make an impact by:** ... heart, each and every day. **Position Summary** Aetna is recruiting for a Senior Manager, Value Based Contractor who will partner with business development and… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development… more
- Cardinal Health (Columbus, OH)
- …of insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid , commercial insurance plans, and managed care preferred. + ... aging reports and work patient accounts to ensure timely resolution and reimbursement . + Contact patients regarding past due balance and/or billing questions and… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... regulatory and/or functional requirements related but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more
- OhioHealth (Marion, OH)
- …audits ie, , Office of the Inspector General, The Joint Commission, Center for Medicare & Medicaid Services, Internal Revenue Service, etc. This position will ... other key stakeholders. Assist in analysis and coordination of amendments, reimbursement , and contractual language changes. Interacts closley with executive team and… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …health record documentation. Knowledge of The Joint Commission requirements, Centers for Medicare and Medicaid Services (CMS), and/or health record documentation ... timelines. Research references to resolve any questionable code errors; contact a senior coder or supervisor when needed. Work within a team environment; support… more
- Molina Healthcare (Columbus, OH)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... manages a team of medical economics team of professionals. * Collaborates with senior level clinicians and leaders from functional areas such as finance, health care… more