- Humana (Providence, RI)
- …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 (Providence, RI)
- …- 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
- Oracle (Providence, RI)
- …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands on… more
- Molina Healthcare (Worcester, MA)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- National Health Care Associates (Stafford Springs, CT)
- …personalized resident care plans and ensures the capture of clinical reimbursement for services provided. **Key Responsibilities:** + Determine Patient Driven ... prospective residents by assessing their nursing needs and determining appropriate clinical reimbursement levels + Complete and assure the accuracy of the MDS… more
- National Health Care Associates (Stafford Springs, CT)
- …for developing personalized resident care plans and the capture of clinical reimbursement for services provided. You will ensure the highest level of revenue ... looking for potential risks and/or changes that may affect reimbursement + May train, mentor and/or manage MDS Coordinators,...teams to ensure accurate data collection for assessments + Provide insights and ongoing education to facility staff and… more
- Gentiva (Warwick, RI)
- …designated teams and functions as an interdisciplinary (IDG) team member to provide care and liaise between physician, patient/family and hospice team. + Performs ... minimum of one (1) year experience as an RN, either in acute care hospital , oncology, long-term care, hospice or home health. + In instances where state-specific… more
- Humana (Providence, RI)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more