- Humana (Trenton, NJ)
- …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 (Trenton, NJ)
- …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
- Humana (Trenton, NJ)
- …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... diverse scope and complexity ranging from moderate to substantial. The Provider Contracting Executive communicates contract terms, payment structures, and … more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Associate Director Reimbursement -Financial Analysis Reimbursement -Corporate 42nd Street-Full-Time-Days** Ensures maximization of ... Third Party Payers abiding by Federal, State and Blue Cross reimbursement regulations and Generally Accepted Accounting Principles. **Qualifications** + Bachelor… more
- Guidehouse (New York, NY)
- …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
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Option Care Health (Trenton, NJ)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Mount Sinai Health System (New York, NY)
- …organization and bridges the gap between clinical care and medical billing and reimbursement . This position will report to the Senior Director. This role will serve ... cycle, ensuring that patient care translates into accurate and timely reimbursement , safeguarding the financial well-being of the organization and contributing to… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Humana (Trenton, NJ)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more
- Ascendis Pharma (Princeton, NJ)
- …deep understanding of US government pricing programs, and the pharmaceutical reimbursement landscape. Key Responsibilities + Lead the end-to-end government pricing ... and annual GP reports to CMS, VA/DoD, and state Medicaid agencies, and any programs requiring price reporting, per...any programs requiring price reporting, per legislative requirements + Provide government pricing impact assessments to aid in the… more
- Atlantic Health System (Morristown, NJ)
- …recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated ... at Morristown Medical Center and offers the opportunity to provide comprehensive care as part of a collaborative and...sick days, and paid holidays + CME allowance and reimbursement for CDS/DEA, licensing, and boards + Tuition … more
- Atlantic Health System (Morristown, NJ)
- …recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated ... who is looking to transition to a Nationally Recognized Hospital ? If so, Atlantic Health is seeking a full-time...care facility and be a team player who will provide exceptional care to our patients. Full Time Team… more
- Atlantic Health System (Morristown, NJ)
- …recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated ... + Generous PTO, annual sick days, and paid holidays + GME allowance and reimbursement for CDS/DEA, licensing, and boards + Tuition reimbursement for advanced… more
- Ascendis Pharma (Princeton, NJ)
- …managers (PBMs). This role requires expertise in contract management and reimbursement dynamics, coupled with strong leadership and analytical skills. The Director, ... and manage accruals for applicable vendor purchase orders. Assess and provide input to department's overall yearly budget. Requirements Key Responsibilities:… more
- Atlantic Health System (Florham Park, NJ)
- …recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated ... including 6 Child and Adolescent Psychiatrists. The candidate will oversee and provide patient care for children and adolescents with psychiatric needs referred from… more
- Atlantic Health System (Morristown, NJ)
- …recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated ... World Report ranked Morristown Medical Center as a top hospital nationwide for cardiology & heart surgery. The Advanced...and Time Off incremental to PTO days + Tuition reimbursement for Advanced Degrees + Outstanding growth & mentorship… more
- Atlantic Health System (Morristown, NJ)
- …recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated ... skills, clinical expertise, and previous experience in a fast-paced practice, hospital service or with stress testing environment. + Master's degree required… more
- Atlantic Health System (Morristown, NJ)
- …appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of ... + Prepares written reports of the audit findings by provider /practice + Follows up with providers as needed until...+ Assists with claim denial reports to ensure optimal reimbursement + Serves as a resource to the office… more
- Molina Healthcare (New York, NY)
- …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