- Movn Health (CA)
- …with a proven track record in A/R recovery, claim appeals, and payer follow-ups. Experience in startup environments and cardiovascular care is strongly preferred. ... Tebra, etc) and QuickBooks, and a strong understanding of medical billing and payer systems is essential. Functional Responsibilities + Submit clean claims via EHR… more
- Select Medical (Los Angeles, CA)
- …and Care Planning Management; Fiscal Management; and Payer /Referral Management. **Responsibilities** + Clinical Interventions/Discharge and Care ... the interdisciplinary plan of care. + Fiscal Management: Assures responsiveness to payer systems by maintaining ongoing communication and serving as the primary… more
- Sanofi Group (Bakersfield, CA)
- …billing and coding, financial assistance offerings, patient support, access, payer medical policy, prior authorization, specialty pharmacy operations, infusion ... be subject matter experts on product procurement as it relates to medical payer policy requirements, buy & bill processes, billing and coding education, claims and… more
- Amazon (San Francisco, CA)
- …tools. Payor & External Engagement - Serve as a key liaison with payer partners; lead discussions to ensure performance meets contractual quality and regulatory ... requirements. - Represent One Medical in payer Quality Committees; support payer -facing medical leaders with preparation and strategy to achieve shared goals. -… more
- Alameda Health System (Oakland, CA)
- …admission orders and documentation to confirm alignment with regulatory requirements and payer guidelines. 5. Review planned admissions to ensure that services are ... medically necessary, appropriately authorized by the payer , and assigned to the correct level of care. 6. Ensure compliance with federal, state, and organizational… more
- Aston Carter (Valencia, CA)
- …Ensure all strategies and communications comply with CMS, Medicaid, and private payer regulations. Essential Skills + Proven success in DME reimbursement expansion ... with private payers and Medicaid. + High-priority payer experience, including Tricare, Kaiser, and Medicaid in Kentucky,...in Kentucky, Louisiana, and Texas. + Strong negotiation and payer engagement skills. + 5+ years in market access,… more
- Cardinal Health (Sacramento, CA)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... appropriate sections of the database + Must track any payer /plan issues and report any changes, updates, or trends...upon by the client + Responsible for reporting any payer issues to the appropriate team + Must self-audit… more
- Cedars-Sinai (Los Angeles, CA)
- …to assure the highest revenue recovery possible. + Oversees the major payer escalation log for trending, reconciling and submission on a monthly basis; ... Able to assist management with special projects and participates on Payer Joint Operating Committee (JOC) meetings. + Completes all necessary research and account… more
- UCLA Health (Los Angeles, CA)
- …also include reviewing coding audits, resolving escalated issues, analyzing payer trends, and implementing departmental improvements in alignment with federal ... questions + Implement quality assurance initiatives, perform post-bill audits, and address payer denial trends + Develop and deliver training programs for new and… more
- UCLA Health (Los Angeles, CA)
- …role, you will: + Manage an assigned portfolio of accounts across payer types, executing complex claim reviews, resolving payment delays, and optimizing collections ... and rebill claims as needed, ensuring compliance with contract terms and payer policies + Maintain thorough documentation in CareConnect and ensure workflows are… more