- First Atlantic Health Care (South Portland, ME)
- …for various payer sources including, but not limited to, Medicare, MaineCare and Managed Care . + Maintain daily census and mix goals per facility budget. + ... Data entry and communication with insurance companies. + Work with Admissions Director to admit patients to facility, verify insurance eligibility, etc. + Expedites… more
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... **Job Description** Under direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager...years of retail pharmacy technician experience or related health care administrative, and a strong familiarity with the prior… more
- Trinity Health (Chelsea, MI)
- …for each patient while adhering to ethical practices per insurance guidelines for each payer . Works with site leader, director and/or secretarial staff to ensure ... adhering to ethical practices per insurance guidelines for each payer . + Works with site leader, director ...director and/or secretarial staff to ensure schedules are managed well to achieve targeted productivity and clinic budget.… more
- HCA Healthcare (Austin, TX)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- AmeriHealth Caritas (Lafayette, LA)
- …+ Minimum of 2 years of Utilization Management experience, preferably in a managed care organization. + Proficiency in Electronic Medical Record Systems and ... policies. When necessary, cases are escalated to the Medical Director for further review. The reviewer independently applies medical...to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and… more
- Diversicare Healthcare Services & Diversicare Ther (Birmingham, AL)
- …all necessary administrative documents, certifications prior to Medicare Part A, Part B, and Managed Care billing. + Ensuring Billing Notes are updated in AHT ... **Pay advancement program - OnShift Wallet** Diversicare provides post-acute care services to patients and residents at 46 skilled...steps for any accounts in question. Include RVP, Sr. Director of A/R, Bookkeeper, VP of Revenue Cycle and… more
- University of Southern California (Los Angeles, CA)
- …and documents avoidable delays in the M drive. * Maintains awareness of current managed care contract requirements. * Participates in appeal process. * Performs ... In collaboration with the interdisciplinary team, provides care coordination services evaluating options and services required to meet an individual's health care… more
- Point32Health (RI)
- …Policy, etc. + Utilizing in-depth understanding of reimbursement methodologies and trends in managed care finance, lead the development and analysis of new ... . **Job Summary** Working under the direction of the Director or Senior Manager, the Senior Network Performance Analyst...professional experience. + Preferred: 5-7 years of experience in managed care or provider environment. New England… more
- Mount Sinai Health System (New York, NY)
- …timely charge capture. + Organizes routine meetings with health system business leaders and managed care to review charge and revenue capture and performance. + ... Senior Revenue Analytics Associate will report to the Senior Director of Revenue Analysis and Reporting of the MSHS....with key stakeholders across departments (eg, DTP, Human Performance, Managed Care , Finance, and clinical departments) +… more
- East Boston Neighborhood Health Center (Revere, MA)
- …EXPERIENCE: One to three year's experience working in a Medical Staff Office, Credentialing or Managed Care in a hospital, managed care insurance, or ... of our patients and communities. Whether you're a nurse or physician providing direct care , a manager leading dedicated teams, or part of the essential support staff… more