- Zelis (GA)
- …& Retention: Responsible for client renewals and retention. Successfully facilitate contract negotiations with their leader and manage the complete life cycle ... + 5+ years in client management role. + Extremely knowledgeable in the Payer space. Experience in working in healthcare including insurance companies, or working… more
- Bon Secours Mercy Health (Toledo, OH)
- …with previous management or leadership experience with Population Health or Value-Based Contract work including but not limited to: direct patient care, managing ... payer relationships or health systems outcomes (required) + Working knowledge and familiarization with process improvement models (such asPDSA andA3) (preferred) +… more
- Rochester Regional Health (Rochester, NY)
- …patient services. Under the general supervision of the Patient Access Services Manager , this position performs imperative duties including registration pre and full, ... computer system reviewing for mandatory precertification and/or other third party payer requirements + Collects complete financial information to include payer… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements * Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate * Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients * Completes all admission… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements + Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate + Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients + Completes all admission… more
- CVS Health (Lansing, MI)
- …groups, and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and ... **Position Summary** In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level review and rate… more
- East Boston Neighborhood Health Center (Revere, MA)
- …state, and payer requirements. + Review and negotiate key financial contracts for PACE, pharmacy vendors, payer agreements, value-based arrangements, and ... HLHC billing and reimbursement preferred + Demonstrated experience with multi- payer environments-including capitation, risk-based contracts , ACO models,… more
- Rochester Regional Health (Rochester, NY)
- …Revenue Cycle + Review and scan insurance cards, checking for precertification and payer requirements. + Collect full financial information: payer name, ID and ... insurance eligibility via appropriate websites. + Complete the Medicare Secondary Payer Questionnaire for eligible patients. + Complete all required Medicare… more
- Hartford HealthCare (Farmington, CT)
- …Ability to identify and communicate payer and/or system trends. . Knowledge of payer contracts , regulations and guidelines, as well as State and Federal laws ... answer questions and provide information. 2. Understands healthcare billing and payer regulations to effectively communicate with patients about charges, payments… more
- 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