- Highmark Health (Camp Hill, PA)
- …control frameworks, and assessment methodologies, particularly as applied to healthcare ( payer and provider) business processes + Knowledge of relevant regulatory ... guidelines, vendor management, sourcing and procurement, and completing assessments of vendors + Excellent resource and project planning capabilities, decision making skills, history of results-oriented delivery, and effective team building across a… more
- Penn State Health (Hershey, PA)
- …clinical data within the patient's EMR. Ability to understand third party payer and insurance complexities. Ability to communicate professionally with all patients, ... peers, providers. Ability to train new hires. Ability to multitask due to the high volume of phone calls. Ability to know and understand complex therapies. **PREFERRED QUALIFICATIONS:** Pharmacy technician or Pharmacy billing experience with Insurers and Third… more
- Cognizant (Harrisburg, PA)
- …ideal candidate will have extensive experience in Kafka and a strong background in the Payer domain. This is a hybrid work model with day shifts and no travel ... required. The candidate will play a crucial role in developing and maintaining our systems ensuring they meet the highest standards of performance and reliability. **Location:** **Owings Mills - MD USA, (Remote** **)** **Candidate must be legally authorized to… more
- Cardinal Health (Harrisburg, PA)
- …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 ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- Penn Medicine (King Of Prussia, PA)
- …financial resources. + Ongoing Patient Support: Review and interpret payer guidelines, investigate alternative payment sources, and ensure accurate documentation ... for reimbursement. Qualifications: + Education: High School Diploma or GED required. An Associate's degree in Business Administration or a related field is preferred. + Experience: At least 2 years of experience in billing, accounts receivable, insurance… more
- UPMC (Moon Township, PA)
- …in a medical office setting + Prefer knowledge of medical terminology; third party payer rules and regulations; and credit and collections laws + Word processing and ... computer experience required preferably including EPIC experience. **Licensure, Certifications, and Clearances:** + Act 34 **UPMC is an Equal Opportunity Employer/Disability/Veteran** more
- The Cigna Group (Philadelphia, PA)
- …and collaborating across functions. **Preferred Qualifications** + Experience in payer , provider, or integrated delivery system environments. + Familiarity with ... value-based care models, population health strategies, or digital health tools. + Exposure to strategic planning, business case development, or healthcare innovation. If you will be working at home occasionally or permanently, the internet connection must be… more
- Select Medical (Canonsburg, PA)
- …address and resolve account inquiries effectively. * Provide feedback on changes in payer plans, contracts, or billing information to the CBO team. * Maintain strict ... compliance with HIPAA regulations. * Assist with additional tasks as assigned when not managing inbound calls. **Qualifications** **Required Qualifications:** + High school diploma or GED. + Minimum of one year of customer service experience. **Preferred… more
- Merck (North Wales, PA)
- …access in collaboration with internal teams, and provide input into clinical, payer /access, marketing and value evidence generation strategies and programs. + In ... collaboration with internal teams and external partners, design non-interventional and data synthesis studies, author study protocols, develop measurement questionnaires, case report forms, data analysis plans, final study reports, scientific presentations,… more
- Evolent (Harrisburg, PA)
- …healthcare end to end system landscape + Good knowledge US Healthcare - Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims ... workflow, members, providers + A minimum of 1 years of experience in technical quality assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans, and… more