- Amgen (New York, NY)
- …physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms + Review ... update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access...benefit design (Commercial, Medicare, Medicaid) + Serve as a payer expert for defined geography and promptly communicate … more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …The Role The ideal candidate is an experienced program manager with healthcare payer / TPA experience who excels in client interaction and can effectively oversee ... directing, and coordinating complex product/program implementation in the HealthCare Payer domain and or Third-party Administration of self-funded clients +… more
- WMCHealth (Hawthorne, NY)
- …position is responsible for providing administrative support for the process of payer enrollment credentialing for the medical staff at Westchester Medical Center ... this position is ensuring that all physicians and allied health professionals are payer enrolled and set up accurately with contracted payers. Work is performed in… more
- Trinity Health (Syracuse, NY)
- …service line. * Maintain subject matter expertise on authorization requirements by payer and order type to ensure proper authorization obtained pre-procedure. * ... state, and local medical policy guidelines. * Initiate Peer to Peer's with payer while working closely with providers and clinical staff to obtain letters of… more
- University of Rochester (Rochester, NY)
- …determine the reason the request was denied and prepares a response to the payer with necessary additional information. + If the denial management needs to involve ... director conversation is needed for approval outside of the payer policy. + Documents all PAs in the appropriate...medical record revenue application as a secondary or tertiary payer . + Works collaboratively with Patient Financial Services to… more
- Rochester Regional Health (Rochester, NY)
- …Revenue Cycle + Review and scan insurance cards, checking for precertification and payer requirements. + Collect full financial information: payer name, ID and ... insurance eligibility via appropriate websites. + Complete the Medicare Secondary Payer Questionnaire for eligible patients. + Complete all required Medicare… more
- Mount Sinai Health System (New York, NY)
- …+ Monitor key performance indicators (KPI) such as initial and final denials, payer performance, staff productivity and quality touches, aged AR trends and billing ... health system business leaders and managed care to review payer issues and denials. + Builds effective, collaborative relationships...+ Maintains strong understanding of revenue performance metrics and payer mix and leads team in building plans to… more
- Sanofi Group (New York, NY)
- …contribute to special projects focused on enhancing Market Access operations (eg, payer onboarding, hub integration, channel expansion) + Maximize digital tools with ... Trade & Channel, or Commercial Operations. + Deep operational knowledge of US payer systems, PBMs, GPOs, and specialty pharmacy distribution. + Proven track record… more
- Albany Medical Center (Albany, NY)
- …registration + Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility + Responsible to ... to maintain the Electronic Health Record + Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration. + Ability to work… more
- Albany Medical Center (Albany, NY)
- …registration + Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility + Responsible to ... to maintain the Electronic Health Record + Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration. + Ability to work… more