- Humana (Raleigh, NC)
- …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 (Raleigh, NC)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Edwards Lifesciences (Raleigh, NC)
- …They will work directly with hospital leaders and physicians to deliver hospital economic analyses customized to each provider . This individual will also ... of reimbursement plans (coding, coverage, payment) unique to each provider . + Articulate a thorough understanding of the structural heart landscape, trends,… more
- Guidehouse (Raleigh, NC)
- …and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. **This position is 100% ... for charge reconciliation audits + Escalate departments noncompliant with policy and provide action plan when needed + Responsible for the daily resolution of… more
- Humana (Raleigh, NC)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
- UNC Health Care (Morrisville, NC)
- …Medicare Advantage and Managed Medicaid policies that could potentially affect reimbursement across UNC Health, whether Hospital based billing or Physician ... Assists with being a resource, answering questions and providing information about Reimbursement Policies that currently, or will in the future, affect UNC Health.… more
- UNC Health Care (Smithfield, NC)
- …Responsible for performing a variety of complex duties in support of reimbursement from patient and insurance carriers throughout the revenue cycle from pre-service ... staff with training or techniques to increase production and quality as well as provide support for the team members that may be absent or backlogged. Perform all… more
- Gentiva (Lillington, NC)
- …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… more
- PruittHealth (Raleigh, NC)
- …levels of care. 2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 3. ... continuum and facilitating admissions into the Pruitt Health network. 5. Must provide excellent customer service to all referral sources and network of providers.… more