- Nuvance Health (Danbury, CT)
- …that provider rosters and locations are current. Responsible for reporting payer credentialing status to WCHN management. Makes suggestions for enhancements/changes ... Medicare & Medicaid services and state requirements. This includes completing Commercial payer , Medicare and Medicaid applications for all WCHN providers as well as… more
- J&J Family of Companies (Hartford, CT)
- …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
- University of Rochester (Rochester, NY)
- …any delays from admission until the final bill is produced and any payer denials associated with the above. **ESSENTIAL FUNCTIONS** + Reviews each visit for ... history by utilizing the hospital system along with all third-party payer systems. + Obtains benefits, pre-certification requirements, and/or completes notification… more
- University of Rochester (Rochester, NY)
- …of revenue has been collected, using detailed understanding and application of all payer contracts. + Contacts applicable agency, payer or department for ... for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection. +...new staff on the use of the billing application, payer systems, and clearinghouse systems. + Demonstrates how to… more
- 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
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