- University of Rochester (Rochester, NY)
- …global transplant payments and initiates transfer of dollars to each provider. 10% Payer Relations + Identifies need for in-person meetings and phone conferences ... staff and outside agencies regarding contractual obligations. Assures on-going positive relations and support of highly visible unique contracts and arrangements.… more
- University of Rochester (Rochester, NY)
- …balance report - - Over $10,000 report - - Claim Edits - - 10% Payer Relations and Escalation Process - Identify and clarify issues that requirement management ... arrangements, and specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Schedule 7:30 AM-4 PM Responsibilities… more
- Stony Brook University (Commack, NY)
- …for contract modeling and financial analysis. + Proven track record of successful payer relations and dispute resolution. + Demonstrated ability to develop ... changes affecting the organization. + Monitor and dispute Managed Care payer reimbursement policies or practices that breach contract terms, track resolution… more
- Humana (Albany, NY)
- …data reporting, performance improvement, physician engagement, informatics, network development, and contract/ payer relations . This design gives the Fellow the ... opportunity to build fundamental communication, analytic, and problem-solving skills as well as an understanding of the ACO environment and population health strategies. To complement on-the-job training, fellows are involved in Board and other administrative… more
- Cardinal Health (Albany, NY)
- …entire network of participating health plans + Cultivate and maintain on-going payer relationships and Medicaid enrollments. + Adhere to cyclical renewal, retrieval, ... and updates per profile + Work closely with third party vendors to identify data needs and execute updates when required + Report results and outcomes of network status to management at regular intervals + Respond to third party/managed care requests in a… more
- Sanofi Group (Albany, NY)
- …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
- Ellis Medicine (Schenectady, NY)
- …communication (verbal, written and phone), interpersonal and positive customer relations skills required. + Certification: n/a RESPONSIBILITIES OF THE POSITION: ... meetings with all payers to continuously improve communications between provider and payer in order to resolve issues, reduce outstanding aged accounts, increase… more
- University of Rochester (Rochester, NY)
- …determine the reason the request was denied and prepares a response to the payer with necessary additional information. + If the denial management needs to involve ... or if physician-to-medical director conversation is needed for approval outside of the payer policy. + Documents all PAs in the appropriate location within the… more
- University of Rochester (Rochester, NY)
- …Chair of Medicine's Office for all faculty appointments, hospital privileging, and payer credentialing- - - Ensure completion of all requirements for timely ... new faculty, interviewing, contracts/recruitment, faculty appointment, hospital privileging, and payer credentialing Other Duties as assigned: - Supports seasonal… more
- University of Rochester (Rochester, NY)
- …not covered. + Determine if home infusion therapy being ordered meets payer requirements for coverage. Retrieve and assemble necessary information for insurance ... patient documentation. Coordinate required information for denied claims. Participate in payer audits and collect, summarize and send requested information. +… more