- Adecco US, Inc. (Irving, TX)
- …access and reimbursement barriers. + Manage benefit investigations, prior authorizations, claims escalations, and appeals. + Deliver payer insights and education on ... Medicare and commercial insurance coverage. + Collaborate with physician offices, specialty...insurance, and specialty pharmacy. + Experience with prior authorizations, claims processing, and appeals. + Strong communication, presentation, and… more
- CSL Behring (King Of Prussia, PA)
- …CRM operations for US sales and customer facing teams. Represents the US commercial organization needs on the global CRM (Veeva) operating committee within the ... Serve as a strategic advisor to US and global commercial leadership, shaping the direction of field operations and...integration of specialty pharmacy data and use of secondary claims data (eg IQVIA claims data) -Experience… more
- Zelis (Plano, TX)
- …Medicaid programs as well as deciphering contractual language regarding commercial payment arrangements. + Draft concise documentation for payment ... team to refine into user stories with acceptance criteria, including creating test cases/ claims with expected pricing outcomes . + Perform analysis of various data… more
- Prime Healthcare (Ontario, CA)
- …documents from internal or external entities, resolving claim rejections, packaging claims , including global billing with attachments of professional fee claims ... office. LI-VR2 #Onsite Qualifications + Minimum of three years hospital managed care/ commercial collector experience. + 2 years of recent hospital Medicare billing… more
- Omaha Children's Hospital (Omaha, NE)
- …Overview** The Insurance Follow-up Specialist is responsible for corresponding with commercial or government insurance payers to address and resolve outstanding ... well-written appeals. **Essential Functions** + Follow up on insurance or government claims to research and resolve unpaid claim and denials in follow-up work… more
- Access Dubuque (Dubuque, IA)
- …over 20 years, Kunkel & Associates has been a leader in the commercial insurance brokerage and consulting industry. We pride ourselves on delivering top-notch ... nursing services, resource consulting, safety and loss control management, and claims management. At Kunkel & Associates, our unique work environment fosters… more
- Henry Ford Health System (Troy, MI)
- …averages, comparing to Government fee schedules and analyzing existing healthcare ( claims ) data and reimbursement terms and payment methodologies; with the goal ... dollar outpatient payments for various payors, including MA, Medicaid and Commercial . 8. Create prospective and retrospective analyses to assess payment… more
- Adecco US, Inc. (Baltimore, MD)
- …the FRM provides expert guidance on benefit investigations, prior authorizations, claims resolution, and appeals. This client- and customer-facing role requires ... high-impact reimbursement cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient access. 3.… more
- Robert Half Accountemps (Atwater, CA)
- …* Process and manage patient accounts, including billing and collections for commercial , Medi-Cal, Medicare, and third-party payers. * Verify insurance coverage and ... ensure claims are submitted accurately and on time. * Communicate...experience in office or medical billing * Knowledge of commercial , Medi-Cal, Medicare, and third-party billing/collection processes. * Familiarity… more
- AON (Houston, TX)
- …guiding clients through both routine decisions and major inflection points, such as claims or new ventures. Cross-functional teamwork is part of the rhythm: whether ... Facilitate strategic relationships between clients, Aon, and insurers. + Evaluate commercial risk financing programs and perform coverage comparisons with brokers… more