- Humana (Providence, RI)
- …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 (Providence, RI)
- …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
- Humana (Providence, RI)
- …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
- 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