- 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
- AdventHealth (Daytona Beach, FL)
- …benefit is achieved or according to standards of practice and payer guidelines. Participates in practice changes resulting from performance improvement activities ... and supports departmental quality standards and initiatives. **The expertise and experiences you'll need to succeed:** **QUALIFICATION REQUIREMENTS:** DoctorateBasic Life Support - CPR Cert (BLS) - RQI Resuscitation Quality Improvement, Physical Therapist (PT)… more
- Select Medical (Myrtle Beach, SC)
- …business development team + Collect co-pays from patients, manage payer approvals and conduct insurance authorizations and verifications **Qualifications** **Minimum ... Qualifications:** + High School Diploma/GED required + 1 Year of Scheduling Experience + 1 Year of Medical Office Experience **Preferred Qualifications:** + Insurance Verification Experience **Additional Data** _Go Anywhere with Us! 1900 centers in 39 states… more
- PruittHealth (Tallahassee, FL)
- …21. Identifies case management, HMO, PPO, insurance companies and other payer referral sources. 22. Determines vulnerabilities of competitive relationships and set ... targets. 23. Joins and participates in appropriate organizations and associations. 24. Documents and reports complaints and service-related issues. **KNOWLEDGE, SKILLS, ABILITIES:** 1. Ability to develop clinical knowledge base to support sales activities. 2.… more
- Elevance Health (Sacramento, CA)
- …of 5 years' experience in a behavioral health setting, either provider or payer ; or any combination of education and experience, which would provide an equivalent ... background. + Current, valid, independent, and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable by state laws) is required. **Preferred Skills, Capabilities, and Experiences:** + Candidates who reside… more
- Insight Global (South Jordan, UT)
- …knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology. * ... Expert coding knowledge (DRG & ICD-10) * Registered Nurse RN (must be inpatient) WITH coding/clinical documentation certification (2 years in clinical documentation) OR IF NOT A NURSE: Degree in RHIM, RHIA, RHIT with medical coding degree or just CCS is fine… more
- Growth Ortho (Brunswick, ME)
- …accurate and up to date including patient name, address, date of injury, payer information, etc. by verifying existing information or entering updated data into the ... computer system. 3. Collects copays and outstanding balances at the time of service. Performs daily payment reconciliation. 4. Answers incoming internal and external calls. 5. Utilizes electronic health record for messaging to/from clinical staff. 6. Enters… more
- UnityPoint Health (Des Moines, IA)
- …medical setting desirable. Working knowledge of medical terminology and third party payer is helpful. Typing skills 40-wpm or keyboard equivalent. Accurate data ... entry and spelling accuracy required. Previous customer service experience desirable. License(s)/Certification(s): Patient Access Certificate and Medical Terminology preferred. Knowledge/Skills/Abilities: Writes, reads, comprehends and speaks fluent English.… more
- UnityPoint Health (Urbandale, IA)
- …with Home Health Conditions of Participation, qualifying home care criteria, payer coverage criteria, and providing visits/treatments consistent with the plan of ... care. . Communicates with Registered Nurse Case Manager/Clinical Supervisor and participates in care coordination to achieve high quality care. . Performs other duties as requested by the Clinical Manager/Clinical Supervisor to facilitate smooth and effective… more