- Beth Israel Lahey Health (Boston, MA)
- …in Healthcare or Retail Pharmacy. 4. Knowledge of prior-authorization workflows, payer relations , prescription claims adjudication, and general reimbursement ... procedures. 5. Ability to develop strong relationships with diverse groups of professionals (physicians, nurses, administration, etc. 6. Experience with computer systems required, including web based applications and some Microsoft Office applications which… more
- Ophthalmic Consultants of Boston (Plymouth, MA)
- …including 3+ years in a director-level role + Expertise in billing operations, payer relations , call center leadership, and staff development + Deep ... understanding of coding standards (ICD-10, CPT, HCPCS) and insurance processes + Proficiency with EHR and PM systems like Epic, Athenahealth, eClinicalWorks, or NextGen + Strong communication and leadership skills to work across departments and with executive… more
- Cardinal Health (Boston, MA)
- **_What Network and Payor Relations contributes to Cardinal Health_** Marketing is responsible for assessing customer needs, market conditions and competition to ... and monitoring the appropriate products and services. Network and Payor Relations is responsible for the development and management of business relationships… more
- Sumitomo Pharma (Boston, MA)
- …- Rare Disease, who will act as the face of SMPA to key payer accounts, policymakers, qualified treatment center (QTC) staff, and market access partners, while ... decisions and help remove barriers to access. **Job Duties and Responsibilities** ** Payer Strategy and Engagement** + Develop and implement strategies aligned with… more
- Humana (Boston, MA)
- …community. This role oversees CenterWell communications strategy, media relations , issues/crisis management, executive communications, M&A communications, internal ... external channels. **Media & External Communications** + Oversee media relations strategy-including proactive storytelling, reactive media management, and relationship… more
- East Boston Neighborhood Health Center (Revere, MA)
- …to enroll a provider with the payers and the requirements of each payer . + Gathers and disseminates information to appropriate administrative stakeholders to ensure ... is accurate and up to date every 90 days to avoid delays with payer credentialing and recredentialing. + Answers phone calls and other inquiries regarding Medical… more
- Humana (Boston, MA)
- …us put health first** The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and ... strict regulatory deadlines. Manages provider audits, provider service and relations , credentialing, and contract management systems. Executes processes for intake… more
- OptiMindHealth (Cambridge, MA)
- …and/or breakdowns that would be critically important to long term referral relations and recommend solutions to OptiMindHealth's Director of Physician Relations , ... 2. Understanding of the practice of medicine including referral relationships, payer requirements and other economic and clinical influences. 3. Experience and… more
- Hologic (Marlborough, MA)
- …insurance claims data (think detective work, but with spreadsheets). + Review insurance payer policies to spot gaps in clinical and economic evidence. + Help develop ... all over the world. On top of hands-on experience in your field, our College Relations team will hook you up with opportunities to learn about the company, meet… more
- Beth Israel Lahey Health (Cambridge, MA)
- …patients with Kiosk check-in as needed. 3. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. ... creates, and assigns the guarantor for each patient, including personal/family relations , workers compensation insurance, third parties, behavioral health, or others… more