- Mount Sinai Health System (New York, NY)
- …by provider, to specified payor and monitors progress for proper reimbursement through established follow-up protocols. 5. Provides contract rate analysis to ... **Job Description** This position serves as Appeals Analyst for Central Billing Office management. Responsible for...Outlook **Responsibilities** 1. Monitors and reports the accuracy of contract reimbursements per payor , for both under… more
- RWJBarnabas Health (Oceanport, NJ)
- …, strongly preferred. + Experience solving difficult problems relating to reimbursement , contract modeling and revenue cycle functions, strongly preferred. ... Senior Analyst (Remote) - Oceanport, NJReq #:0000150834 Category:Professional /...language review and communication with insurance companies. + Evaluate payor performance relating to profitability, benchmarking, denials, contract… more
- BrightSpring Health Services (Denver, CO)
- …to support payor negotiations + Develops financial models to project reimbursement rates, financial impacts, and potential risks associated with contract ... through our growing network of branches and healthcare professionals. The Senior Analyst - Revenue Management is responsible for the day-to-day analysis and… more
- UTMB Health (Galveston, TX)
- …Perform financial analysis utilizing the contract management system to review overall payor reimbursement as compared to costs. + Facilitate contract ... Revenue Integrity Analyst - RCO, UTRGV **Galveston, Texas, United States**...modeling and reimbursement impact analyses of proposed contract changes to support negotiations. + Assess opportunities to… more
- RWJBarnabas Health (West Orange, NJ)
- …Service Line performance, Strategic Planning initiatives, Compliance, Managed Care Payor performance, Regulatory reporting, Purchasing Contract initiatives, and ... Sr Decision Support Analyst , Hybrid, New JerseyReq #:0000167696 Category:Information Systems and...to Operating statements. Strong analytical skills, knowledge of healthcare reimbursement and cost, and the ability to produce meaningful… more
- Healthfirst (NY)
- …or reimbursement model design + Experience with Govt and proprietary payor reimbursement methodologies and unit cost management + Strong understanding of ... Responsibilities: + Develop tools and processes for efficient operational and reimbursement management of hospital and physician partners. + Evaluate Medical Trend… more
- Centene Corporation (Lansing, MI)
- …all policies and procedures for the Health Plan including adherence to state contract and guidelines + Request and/or assist in the development of correction action ... issues + Ensure compliance with NCQA, URAC, federal, state and payor standards **Education/Experience:** Bachelors' degree in Public Health, Business, related field… more
- CVS Health (Olympia, WA)
- …understanding of Aetna's Dental Products and market position. Negotiation of contract language and provider compensation. Review quality and service reports with ... limited to termination requests, tax id changes, hold requests, claim reimbursement , system, directory accuracy and various contractual issues. Documented resolution… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Additional responsibilities include reviewing current managed care contracts, validating contract compliance, and addressing changes impacting these contracts. . ... Additional responsibilities include reviewing current managed care contracts, validating contract compliance, and addressing changes impacting these contracts. **KEY… more
- Spectrum Billing Solutions (Skokie, IL)
- …100% fully remote. Your Responsibilities: + Complete provider credentialing and contract applications with third-party carriers and government health plans. + Review ... in credentialing and contracting. + Knowledge of Commercial Insurance and Government Payor guidelines. + Ability to plan, organize, and complete work with competing… more