- CareFirst (Baltimore, MD)
- …of the strategic and financial goals of a health care system, payer organization, health plan and/or health insurance operations (eg networks, eligibility, benefits) ... . + The incumbent must have the ability to adapt to change while positively encouraging and motivating team members. + The incumbent will have an onsite hospital-based assignment and must be able to travel onsite to their hospital-based assignment up to 5 days… more
- Scripps Health (San Diego, CA)
- …the patient visit; verifying coverage including benefits, authorization, pre-determination, payer specific policy exclusions or limitations to coverage, collecting ... any patient responsibility and accurately preparing end of day reporting or payment reconciliation as needed. * Assisting patients with HPE eligibility, discussing payment arrangement options including financial assistance information, providing price… more
- Cognizant (Long Beach, CA)
- …understanding of Pega Process Modeling and Pega Process Analysis + Domain expertise in Payer ; experience in Provider is a plus **These will help you stand out** + ... Hands-on experience with Pega Mobility to enable mobile access to applications + Familiarity with Pega Express for rapid application development and deployment + Demonstrated success in managing Pega Case Management processes + Experience implementing decision… more
- Select Medical (St. Petersburg, FL)
- …business development team + Collect co-pays from patients, manage payer approvals, and conduct insurance authorizations and verifications **Qualifications** ... **Minimum:** + High School Diploma or GED + 1 Year Front Desk Experience **Preferred:** + Insurance Verification Experience + Bilingual (Spanish) **Additional Data** _Equal Opportunity Employer/including Disabled/Veterans_ Apply for this job… more
- Regeneron Pharmaceuticals (Little Rock, AR)
- …understanding of regional and local health care delivery, influencers and payer systems. + Proactively identify business opportunities with assigned accounts and ... leads appropriate coordination of effort by the Regeneron Oncology account team, eg supports contracting pull-through with accounts. + Develop a breadth of relationships within each account to ensure an understanding of each account's objectives, goals, and… more
- Elara Caring (Paterson, NJ)
- …and operational planning efforts + Ensure ongoing compliance with all licensure, payer , contract, and regulatory standards + Provide guidance, coaching, and support ... to caregivers to promote performance and engagement + Ensure caregiver compliance with required trainings, certifications, health assessments, and in-services + Conduct caregiver orientations as required + Collaborate with payroll and timekeeping teams +… more
- Walgreens (Guaynabo, PR)
- …but not limited to Medication Therapy Management programs, Immunization Services, and Payer and Pharma Adherence & Clinical Programs. Drives the execution of ... multiple business plans and projects to ensure business needs are being met. + Drives compliance and continuous quality improvement in the delivery of clinical pharmacy patient care and services by studying, evaluating, and re-designing processes; monitoring… more
- TEKsystems (Houston, TX)
- …carriers to management + Contact patients when documentation does not meet payer guidelines Qualifications + Strong attention to detail and problem-solving skills + ... Ability to navigate multiple systems efficiently + Excellent communication skills + Previous customer service experience preferred Why Join Us? + Remote work flexibility + Opportunity to make a meaningful impact in patient care + Supportive team environment… more
- Sanford Health (Sioux Falls, SD)
- …practices, including reimbursement of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private sources, ... as applicable. Demonstrate extensive advanced knowledge of medical principles, practices and techniques. This role will require varying shifts, on-call rotations, including nights, and weekends as needed. **Qualifications** Completion of a master's,… more
- Lilly (Houston, TX)
- …grow and own business outcomes. + Navigates the ever-changing healthcare environment and payer landscape to increase understanding of accounts and be able to impact ... key stakeholders to become trusted partners. + Utilizes appropriate business insight tools, data, and analytics to identify trends, priorities, opportunities, and potential obstacles. + Implements and adopts new technologies, including the integration of AI… more