- Ascension Health (Nashville, TN)
- …plans. + Lead or participate in payer negotiation processes and major payer relations discussions. + Maintain knowledge of assigned market(s) or segment(s) ... range at the time of the offer._ **Responsibilities** Oversee payer revenue strategy and contracting for one or more...including the organization's delivery footprint and the payer and competitive environment. Support and integrate business plans… more
- Community Health Systems (Franklin, TN)
- …in care management preferred + 1-2 years of experience in utilization management, payer relations , or hospital revenue cycle preferred **Knowledge, Skills and ... hospital resource utilization, reduce readmissions, and maintain compliance with payer requirements. **Essential Functions** + Performs admission and continued stay… more
- HCA Healthcare (Nashville, TN)
- …support to various teams, including payer contracting and analytical teams, payer relations , managed care, legal support, and service line leaders. Your ... best practices when collaborating with customers and peers. + Assist the Payor Relations Managed Care teams and Managed Care Legal teams in proactively preparing for… more
- HCA Healthcare (Hendersonville, TN)
- …member of hospital's peer review committees as requested. Business Development and Payer Relations : + Evaluates clinical appropriateness of new medical ... services to facility-level physician credentialing, business development, and provider relations in contracting issues. + Provides medical consultation on… more
- Covenant Health Inc. (Knoxville, TN)
- …from third-party payers. + Maintains accountability for system master file integrity, payer monitoring, and customer relations . + Leads the development and ... improve cash collections, and ensure compliance with federal, state, and payer regulations. This position collaborates closely with hospital units, medical staff,… more
- Adecco US, Inc. (Knoxville, TN)
- …cashiering, etc.) + Responsible for Patient Accounting system master file integrity, payer monitoring, and customer relations . + Remain current on procedural ... and regulatory changes issued by Medicare, TennCare, managed care payers, and agencies. Communicate updates to staff and other departments that need to know. + Utilizes resources available appropriately, ie use of system equipment and/or supplies. + Ensures… more
- Cardinal Health (Nashville, TN)
- **_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
- Covenant Health Inc. (Knoxville, TN)
- …This position demonstrates the ability to accurately submit claims in all payer categories, ie, Medicare, TennCare, Blue Cross, Commercial, and Managed Care. This ... timely manner. Analyzes claim edits within billing system and payer sites with a variety of different issues, such...duties as assigned or requested. + Promotes good public relations for the department ad the facilities, adhering to… more
- Covenant Health Inc. (Knoxville, TN)
- …medicine and urology. Position Summary: Demonstrates knowledge of Medicare and payer billing guidelines and policies. Demonstrates ability to promptly review, ... interpret and communicate current and changes to published Medicare and other payer billing guidelines/policies. The Billing Liaison must be able to answer policy… more
- Covenant Health Inc. (Knoxville, TN)
- …course of action for proper resolution. + Responsible for learning & understanding payer rules, as well as state/federal guidelines. + Responsible for prioritizing & ... guidelines, HCFA guidelines, TennCare guidelines and other Third Party Payer requirements assuring departmental compliance. + Recognizes situations, which… more