- UTMB Health (Galveston, TX)
- …and understanding of all state and federal laws, rules, and regulations regarding payer billing guidelines + Demonstrates a basic understanding of CPT, ICD-9, HCPCS, ... payers and/or clients for hospital and/or Professional Patient Accounts + Resolves Payer rejections from billing system daily to bill submit hospital and/or… more
- Baylor Scott & White Health (Temple, TX)
- …subqueries, performance tuning + Basic to intermediate PL/SQL + **HealthEdge HealthRules Payer ** + Hands-on experience with HealthRules Payer (HRP) + Knowledge ... of claims processing, benefit configuration, and payer workflows + **Troubleshooting & Support** + Strong analytical and problem-solving skills + Experience… more
- Novo Nordisk (Houston, TX)
- …basis with territory level impact + Demonstrates understanding of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer ... gain commitment to utilize NNI products for appropriate patient types utilizing payer opportunities, brand/sales strategies and objectives in order to meet territory… more
- Cardinal Health (Austin, TX)
- …collections + Ensure all oncology-related claims are submitted accurately and within payer timelines to prevent denials and delays + Support change management with ... implement strategies to safeguard reimbursement, including proactive AR management and payer follow-up + Collaborate with operations, clinical, and financial teams… more
- Cardinal Health (Austin, TX)
- …to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage the daily ... of escalation for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends… more
- Cardinal Health (Austin, TX)
- …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 ... a timely manner + Mediate effective resolution for complex payer /pharmacy issues toward a positive outcome to de-escalate +...appropriate sections of the database + Must track any payer /plan issues and report any changes, updates, or trends… more
- Lundbeck (Dallas, TX)
- …status and program eligibility + Educate providers and key stakeholders on payer processes and procedures + Meet face-to-face or virtually to answer technical ... a deep subject matter expert on the local market access expertise including payer landscape for Lundbeck specialty products + Provide education to accounts and field… more
- Cardinal Health (Austin, TX)
- …market shifts and aligning SNS's capabilities with evolving provider, payer , and pharma needs. Through leadership of a cross-functional insights ... M&A activity, and emerging scientific trends impacting provider networks and payer strategies. + Leverage real-world data (RWD) and commercial analytics to… more
- AccentCare, Inc. (Dallas, TX)
- …using internal data applications and + reporting tools. Obtain external data from payer or government websites as needed. + Maintain monthly MC logs that summarize ... websites to generate historical volume/revenue/profitability trending reports and/or new payer potential to aid with rate proposal development and negotiation… more
- Oracle (Austin, TX)
- …develop business models, system strategies, and customized solutions for each healthcare payer . An Oracle Health Insurance (OHI) Senior Principal Consultant must be ... for the US healthcare payers. Specific responsibilities include gathering payer system requirements, understanding Medicare and Medicaid benefits structures, and… more
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