- Humana (Columbus, OH)
- …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
- 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
- Dayton Children's Hospital (Dayton, OH)
- …interpreting CPT guidance + Experience in healthcare billing, CMS Medicare and Medicaid reimbursement methodologies + Proficiency in Microsoft Office Tools ... decision making related to chargemaster requests. The position will also provide operational analytical support with regards to reimbursement , charge lag,… 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 (Cincinnati, 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 (Cincinnati, 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
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- … reimbursement , workload, accepted nomenclature, and proper sequencing. Ensure provider documentation is complete and supports the diagnoses and procedures coded. ... skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices,… more
- OhioHealth (Marion, OH)
- …physician and physician group contracts are in full compliance with hospital policies and governmental regulations, (b) manage the physician payroll process ... payment administration, monthly variance reporting and reconciliation process for hospital contracted or employment services physician or physicians groups for… 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
- Oracle (Columbus, OH)
- …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 (Cleveland, 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 (Cleveland, 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 (Dayton, 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
- Gentiva (Wintersville, OH)
- …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
- Fresenius Medical Center (Huber Heights, OH)
- …+ Rated as one of Forbes' US Best Employers + Paid one-on-one training + Tuition reimbursement + Competitive Pay & Benefits + Paid time off + 401(K) and much more + ... blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor… more
- Fresenius Medical Center (Toledo, OH)
- …* Rated as one of Forbes' US Best Employers * Paid one-on-one training * Tuition reimbursement * Competitive Pay & Benefits * Paid time off * 401(K) and much more ... blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor… 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
- Cleveland Clinic (Independence, OH)
- …Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless ... of initial referral with all necessary information to qualify for insurance reimbursement . + Verify warranty times on respiratory therapy equipment at patient's… more