- University of Southern California (Alhambra, CA)
- …be followed, based upon the type of financial class, eg, contracts , private insurance carrier, HMOs, government programs, Federal/State/Local, Self-Pay accounts in ... claim form(s) or billing system for which departmental and payer guidelines stipulate should not be billed to the...identified billing issues and trends to Supervisor and Billing Manager in a timely manner. Communicates issues with claim… more
- KPH Healthcare Services, Inc. (Hoffman Estates, IL)
- …contractual relationships and ensures that clients are admitted according to contract provisions. + Maintains comprehensive working knowledge of community resources ... personnel and referral sources + Consults with the case manager or supervisor for any of the following: +...pending unresolved coverage issues + Obtaining initial authorization from payer sources to begin services + Obtains authorization from… more
- University of Washington (Seattle, WA)
- …to reimburse the UW Medicine for services in accordance with the payer -provider contract , and works diligently toward the identification, mitigation, and ... provided at the Medical Centers. **PRIMARY JOB RESPONSIBILITIES** + Document all payer communications thoroughly, and communicated payer decisions in a timely… more
- Novo Nordisk (Midland, MI)
- …co-promotion partners. Internally, the CMCS I reports to the Portfolio District Business Manager of the specific sales territory. The CMCS I also interacts and ... basis with territory level impact + Demonstrates understanding of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer … more
- Lilly (Indianapolis, IN)
- …product pricing, reimbursement, and access (PRA), grant submissions and contracts ; contacts with regulatory and other governmental agencies; outreach medical ... and Value Proposition that addresses key customer needs (patient, provider, and payer ); the product lifecycle plan, clinical strategies, development plans and study… more
- Tidelands Health (WV)
- …a clean claim including special billing procedures that may be defined by a payer or contract . + Review and resolve account checks, clearinghouse rejection ... + Analyze clinical data and interpret information. + Have knowledge of payer guidelines related to MUE, Medical Necessity, LCD/NCD requirements and HIPAA/Compliance… more
- Open Mind Health (NE)
- …policies to ensure smooth operations and high compliance. + Assist with periodic payer contract reviews. + Actively seeks continuous quality improvement and ... LOCATION: REMOTE REPORTS TO: CLIENT LIAISON MANAGER ABOUT OPEN MIND HEALTH We are a...ongoing monitoring. + Has worked with a variety of payer portals including Aetna, Blue Cross Blue Shield, Optum,… more
- HCA Healthcare (Reston, VA)
- …including the implementation of budgetary guidelines. Supports the Therapy Services Manager in managing the resources of the Rehabilitation Department in an ... for the negotiation of rehabilitation specific rates in negotiated payment structures/ contracts . + In collaboration with the Medical Director and other clinical… more
- IQVIA (Phoenix, AZ)
- …are excited to announce that currently we are looking for a **National Account Manager ** to join our team of over 10,000 global field representatives in several ... accounts, under the direction of the project's Client Lead. This includes developing contracts to optimize plan access, creating and following a strategic sales plan… more
- Rush University Medical Center (Oak Park, IL)
- …Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly desired. * Working ... functions consistent with Federal, State and Local regulatory agencies and payer requirements, and organizational policies and procedures, including HIPAA privacy… more