- Humana (Atlanta, GA)
- …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 (Atlanta, GA)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts. The Senior Provider ... data requires an in-depth evaluation of variable factors. The Senior Provider Contracting Professional communicates contract terms, payment structures, and … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …healthcare and transplants preferred. + Strong knowledge of Medicare and Medicaid reimbursement regulations. + Excellent analytical and problem-solving skills. ... preparing to report on all supplemental Federal and State reimbursement matters + Coordinates Medicare and Medicaid ...with priority focus on billing changes impacting physician and hospital chargemasters + Assist with Provider based… more
- Humana (Atlanta, GA)
- …- 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
- Emory Healthcare/Emory University (Duluth, GA)
- …screening process to patients, patients families, and legal guardians in a hospital setting. + Secure maximum reimbursement through up front identification ... career and be what you want to be. We provide : + Comprehensive health benefits that start day 1...start day 1 + Student Loan Repayment Assistance & Reimbursement Programs + Family-focused benefits + Wellness incentives +… more
- Molina Healthcare (Atlanta, GA)
- …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
- Waystar (Atlanta, GA)
- …of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare ... Integrity products + Ability to interpret regulatory guidelines from CMS, Tricare, and Medicaid websites + Ability to understand the vocabulary used in hospital … more
- Gentiva (Alpharetta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …(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
- Waystar (Atlanta, GA)
- …post-acute providers, and/or payers. + Demonstrates an understanding of evolving reimbursement models, including commercial payers, Medicaid , and Medicare. + ... a member of the Customer Success Organization who will provide clinical insight into product development and testing as...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Waystar (Atlanta, GA)
- …of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare ... hospitals and health systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out our organizational values:… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …to reach new heights in your career and be what you want to be. We provide : + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & ... Reimbursement Programs + Family-focused benefits + Wellness incentives +...community resources. Maintains a thorough working knowledge of Medicare, Medicaid and private payer regulations and processes. Maintains broad… more
- PruittHealth (Atlanta, GA)
- …levels of care. 2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 3. ... continuum and facilitating admissions into the Pruitt Health network. 5. Must provide excellent customer service to all referral sources and network of providers.… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …to reach new heights in your career and be what you want to be. We provide : + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & ... Reimbursement Programs + Family-focused benefits + Wellness incentives +...members. + Performs all aspects of benefits verification. + Provide financial assistance for assigned sections when required. +… more
- Humana (Atlanta, GA)
- …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