- J&J Family of Companies (Jacksonville, FL)
- …and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the decision to start ... appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core and… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide product access expertise to healthcare offices + ... with internal and external stakeholders + Review and educate offices on payer policies, including prior authorization requirements + Provide feedback to internal… more
- AdventHealth (Maitland, FL)
- …on the revenue cycle of AdventHealth. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms. This ... and operational contract issues while actively contributing to the provider payer relationships. Responsible for engaging in communication with Physician Enterprise… more
- Sanofi Group (St. Petersburg, FL)
- …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
- TEKsystems (Tampa, FL)
- …role ensures coding compliance in accordance with official coding guidelines, payer policies, and regulatory requirements to optimize reimbursement and support the ... and HCPCS Level II codes in accordance with CMS, AMA, ASC, and payer -specific guidelines. * Apply correct modifiers to reflect the procedure performed, laterality,… more
- University of Miami (Miami, FL)
- …+ Follows the authorization process using established criteria as set forth by the payer or clinical guidelines + Accurate review of coverage benefits and payer ... and or guidelines + Serves as a resource to provide education regarding payer policies and facilitates coordination of alternative treatment options + Ensures and… more
- University of Miami (Miami, FL)
- …+ Follows the authorization process using established criteria as set forth by the payer or clinical guidelines + Accurate review of coverage benefits and payer ... the treatment plan, serves as a resource to provide education regarding payer policies and assists with coordination of alternative treatment options + Ensures… more
- Caris Life Sciences (Tallahassee, FL)
- …employer groups (employee benefit plans). Responsible for obtaining positive payer coverage policies, securing in-network contracting and maximizing reimbursement ... + Contract and be an in-network provider for insurance companies and group payer organizations within region. + Manage complex contract negotiation and work with… more
- Cardinal Health (Tallahassee, FL)
- …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
- Cordis (Miami Lakes, FL)
- …are identified and addressed. The position requires a strong understanding of US payer systems and provider billing processes, and the ability to translate policy ... and internal stakeholders to identify trends in reimbursement performance and payer behavior. Translate insights into actionable strategies that inform pricing,… more
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