- OhioHealth (Columbus, OH)
- …This position will be responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is ... projects as assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining...Hospice. Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement . Provide… more
- Humana (Columbus, OH)
- …- 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
- Molina Healthcare (Columbus, OH)
- …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes * Provides data driven analytics to finance, ... performance is achieving desired results. * Keeps abreast of Medicaid and Medicare reforms and impact on the Molina...* Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment,… more
- Molina Healthcare (Columbus, OH)
- …and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and ... **JOB DUTIES** + Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to… more
- Gentiva (Columbus, OH)
- …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
- Molina Healthcare (Columbus, OH)
- …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
- Molina Healthcare (Columbus, OH)
- …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
- Molina Healthcare (Columbus, OH)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- Pfizer (Columbus, OH)
- …decision making roles of all levels at integrated health systems, large hospital systems, health insurance plans, state departments of health, county/city health ... programs. This includes a clear understanding of the commercial, Medicaid and Medicare landscape as it relates to the...to educate colleagues across Pfizer on insights gained. * Provide the marketing and strategy teams with key local… more
- Humana (Columbus, OH)
- …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