- Penn Medicine (Philadelphia, PA)
- …the evaluation, reporting and monitoring of all aspects pertaining to pharmacy payer audits and regulatory compliance. + The Ambulatory Regulatory Technician is ... responsible for helping to manage the internal and external pharmacy payer audits and requirements in accordance with Federal, State and Internal auditing standards.… more
- Guthrie (Sayre, PA)
- …on unresponded claims. Works denied claims by following correct coding and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing ... ensure accurate and timely claim submission to individual payers. Reports possible payer or submission issues. 2. Works closely with a Denial Resolution Specialist… more
- Sanofi Group (Pittsburgh, PA)
- …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
- UPMC (Pittsburgh, PA)
- …LOC (Skilled, Rehab, Home Care, DME, etc.) and obtain all necessary payer authorizations for post-acute care. + Documents Freedom of Choice re: post-acute ... documentation requirements, level of care, insurance coverage issues, specific payer and government policies and post-acute services coverage and availability.… more
- J&J Family of Companies (Horsham, PA)
- …demonstrate robust value insights translated into timely patient, provider, and payer -centric scientific communications. **You will be responsible for** **:** In ... as needed + Develop a deep understanding of US payer needs and integrate such insights, in partnership with...RWV&E and market access activities such as shaping of payer communication materials to support market access scientific strategies… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …claims to payers. Verify all services delivered are billed to the correct payer . Work all pre-billing/post-billing reports to ensure correct data on claims. Identify ... claim issues. Guarantee timely secondary billing submissions based on the payer requirements. Complete understanding of contract requirements of each payer… more
- Guthrie (Troy, PA)
- …claims in a timely manner + Securing authorization as appropriate + Documenting payer authorization + Facilitating issue resolution with payer sources in ... or clinic offices as appropriate + Demonstrating ongoing competence in payer requirements, as defined collaboratively with Patient Business Services and Care… more
- Organon & Co. (Plymouth Meeting, PA)
- …will possess deep expertise in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and Medicaid. The role will also ... Expertise:** Serve as an expert in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and Medicaid. Serve as an expert on… more
- Penn Medicine (Philadelphia, PA)
- …workflow, phone calls and/or email + Obtains information to complete Medicare Secondary Payer Questionnaire and other payer specific documents as required + ... for enrollment in available credit option programs. + Effectively communicates with payer to determine extent of coverage and other limitations or co-payments… 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 ... 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