- National Vision (Duluth, GA)
- …support personnel in sales audit and accounting. + Evaluating managed care payer agreements to determine revenue recognition treatment or other new revenue ... agreements. + Evaluating managed care payer agreement reimbursement rates to determine payer ...care payer agreement reimbursement rates to determine payer reserve analysis + Monitoring billing, claims processing, and… more
- Truman Medical Centers (Kansas City, MO)
- …financial sustainability and mission-driven delivery of care through strategic payer engagement, effective contract negotiations, and robust compliance oversight. ... VP will develop and execute innovative, data-driven strategies that enhance payer relationships, expand market reach, and optimize reimbursement outcomes. This… more
- Robert Half Accountemps (Rochester, NY)
- …are sent to primary and secondary insurances. Research and resolve denials and payer requests for information promptly and accurately in order to secure payment. ... denials according to established processes. Research and resolve denial issues via the payer website, coverage policies and/or phone calls to the payer . Submit… more
- J&J Family of Companies (Tucson, AZ)
- …and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the decision to start ... appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core and… more
- AbbVie (North Chicago, IL)
- …Disease (PsD) This role will leverage your clinical understanding, deep global payer knowledge, and competitive insights to shape Access deliverables for Skyrizi ... deliverables and communications. Update global access materials (IAS, value proposition, payer objection handler, negotiation pathway, etc.) based on market insights… more
- TEKsystems (Englewood, CO)
- …outcomes. As a Medical Appeals Specialist, you'll combine deep payer policy knowledge with analytical problem‑solving-owning complex research, writing strategic ... monthly team targets. + Conduct horizontal audits (underpayments across a single payer ) and vertical audits (similar denial reasons across multiple payers). + Lead… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and ... Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and… more
- Waystar (Atlanta, GA)
- …Rules & Edits Manager and has the responsibility for establishing new client payer edit configurations. The goal of the position is to ensure implementation clients ... experience to advise clients in best practices and build a comprehensive payer edit library. The Consultant will partner with Client Operations, Client Success… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and ... Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and… more
- University of Utah Health (Salt Lake City, UT)
- …**- Analytical (data trends) and reporting.** **- Understanding of payer contracts and reimbursements.** _As a patient-focused organization, University of ... accounts. + Develops and manages escalation pathways for unresolved claims or payer disputes. + Implements process improvements for admissions, billing, third party … more