- Cognizant (Austin, TX)
- …Integration, User Experience, and Case Management. If you bring experience in the Payer domain, you'll add valuable insight to our solution delivery. **In this role, ... attention to detail. **These will help you stand out:** + Experience in the Payer domain. + Familiarity with Agile practices. + Ability to mentor peers and document… more
- HCA Healthcare (Dallas, TX)
- …role:** + You will post all payments and adjustments daily + You will contact payer and initiate requests for payment and refunds for overpayment + You will enter ... Strong cash posting experience + Solid understanding of managed care, payer contracts, insurance carriers, financial ledgers, refunds and credit balance resolution.… 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 ... timely manner. The Coordinator, Individualized mediates effective resolution for complex payer /pharmacy issues toward a positive outcome and provides a positive… more
- AbbVie (Houston, TX)
- …managed healthcare, and/or market access in neuroscience in Managed Health Care, Payer Account Management, Field Reimbursement Manager or equivalent role + Minimum 3 ... equivalent industry experience required. + Thorough understanding of the technical payer policy processes, systems and requirements for coverage, coding and payment… more
- Walgreens (Houston, TX)
- …of customer service (including patients, providers, and pharmaceutical and payer partners), and developing and protecting department assets. **Job Responsibilities** ... pharmacy department employees are trained on all required functions regarding payer and pharmaceutical contractual requirements (adverse event reporting, data and… more
- Humana (Austin, TX)
- …cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code ... cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code… more
- Adecco US, Inc. (Irving, TX)
- …manufacturer partners to resolve reimbursement challenges and deliver critical education on payer landscapes and available support services. The FRM acts as a ... Education (25%)** - Educate providers on benefit verification, prior authorization, payer trends, and support center services. Document and report all interactions… more
- Sumitomo Pharma (Austin, TX)
- …goal of supporting attainment of coverage goals and maximizing net revenue + Develop payer & provider deal models to assess the implications of deal scenarios on ... and developing new approaches, processes and methodologies + Experience evaluating PBM/ payer contracts to ensure they support Market Access objectives +… more
- CenterWell (Austin, TX)
- …identify educational opportunities. + Conduct research as needed. + Participate in Payer calls/chart reviews. + May participate in provider education programs on ... guidelines, healthcare regulations (including HIPAA, state and federal compliance), and payer requirements + Proficiency in Microsoft Office Suite (Word, Excel,… more
- TEKsystems (Addison, TX)
- …to present a strong case for claim reconsideration. - Stay up-to-date with payer policies, regulations, and industry trends related to claim appeals and arbitration. ... insurance denials, appeals, and arbitration processes, including knowledge of payer -specific appeal requirements and guidelines. - Strong understanding of medical… more
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