- 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
- Gilead Sciences, Inc. (Santa Monica, CA)
- …in 2L RR-MM. Working closely with HEOR/RWE to ensure the production of compelling Payer Value Evidence tools to ensure rapid access. **Key Responsibilities** : + Key ... plans to ensure that Kite pursues evidence generation plans that are meeting payer needs and ultimately, Kite's commercial ambitions + Provide input into clinical… more
- J&J Family of Companies (Fresno, CA)
- …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
- Community Health Systems (Birmingham, AL)
- …also supports team training, assists with audits, and ensures compliance with payer regulations and company policies. **Essential Functions** + Serves as the primary ... and processes insurance claims, ensuring timely submission and compliance with payer guidelines. + Identifies and resolves credit balances, reclassifies revenue, and… more
- University of Rochester (Rochester, NY)
- …delays from admission/arrival until the final bill is produced and any payer denials associated with the above. **ESSENTIAL FUNCTIONS** _Customer Interactions_ + ... history by utilizing the hospital system along with all third-party payer systems. + Obtain benefits; pre-certification requirements and/or completes notification of… more
- Geisinger (Scranton, PA)
- …tool to ensure that patients meet appropriateness of the setting. + Actively involves payer liaison role in any case that has potential of not meeting medical ... necessity guidelines. + Supports payer liaison role to resolve barriers through appropriate administrative...appropriate administrative and medical channels to avoid third party payer denials. + Maintains awareness of all concurrent denials… more
- WellSpan Health (Lewisburg, PA)
- …timely payment on accounts in accordance with current government and payer regulations. **Duties and Responsibilities** **Essential Functions:** + Corrects financial ... needed.- Reviews remittance advice (835) to ensure proper reimbursement.- Accesses external payer sites for payer policies, claim investigations, and claim… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …aspects of the revenue cycle, including insurance verification, authorizations, billing, payer performance, and reimbursement. This role serves as a key liaison ... to assignment): + Collections: Comprehensive understanding of collection processes across all payer types (Medicare A/B, Medicaid, FFS, PDGM, and Managed Care for… more
- Covenant Health Inc. (Knoxville, TN)
- …This position demonstrates the ability to accurately submit claims in all payer categories, ie, Medicare, TennCare, Blue Cross, Commercial, and Managed Care. This ... in an accurate and timely manner. Analyzes claim edits within billing system and payer sites with a variety of different issues, such as improper match of diagnosis,… more
- Beth Israel Lahey Health (Wakefield, MA)
- …Director, Payor Operations will assist in overseeing and managing operations and payer partnerships for all BILHPN contracted payors. The Director will help develop ... include: being a Risk Bearing Provider Organization (RBPO) and Certified ACO and payer submissions, processes, and tracking. * Directs BILHPN wide aspects of payor… more