- UPMC (Pittsburgh, PA)
- …experience, and/or legal experience, preferably on the insurance ( payer ) side preferred. + Pennsylvania-specific compliance experience preferred.Licensure, ... Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran more
- Beth Israel Lahey Health (Boston, MA)
- …for scheduled visit and documents in the system. Document appropriate payer information, including worker's compensation and auto liability. + Informs patient ... of necessary preparation for scheduled visit, including providing documents, films and notes from other providers, required preparation and protocol for diagnostic tests and procedures. + Coordinates and interprets multiple data sets required for efficient… more
- Billings Clinic (Billings, MT)
- …of CMS requirements and readmission penalties. *Maintains working knowledge of insurance/ payer benefits. Evaluation *Monitors the need for revisions in the plan ... of care and makes recommendations to the multidisciplinary/healthcare team when indicated. Modifies the plan of care/goals to reflect changes in patient or their support system status and needs. *Monitors, evaluates and documents patient progress related to… more
- Centene Corporation (Olympia, WA)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform on-site visits to assess member's needs and ... collaborate with providers or resources, as appropriate + May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits + Other duties or… more
- Sanford Health (Bemidji, MN)
- …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
- Presbyterian Homes and Services (Dubuque, IA)
- …in electronic medical record. + Demonstrate understanding and knowledge of payer sources and regulatory requirements. + Complete and document supervisory visits ... per regulations. + Communicate effectively with residents/clients, families, caregivers, physicians, referral sources, and interdisciplinary team. Qualifications + Graduate from an accredited Occupational Therapy program. + Current licensure in the state(s) of… more
- Centene Corporation (Springfield, IL)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform on-site visits to assess member's needs and ... collaborates with providers or resources, as appropriate + Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits +… more
- Centene Corporation (Olympia, WA)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform on-site visits to assess member's needs and ... collaborate with providers or resources, as appropriate + May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits + Other duties or… 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. **Qualifications** Completion of a master's, postmaster's, or doctorate from an nurse practitioner program accredited by the Commission on the Collegiate… more
- R1 RCM (Milwaukee, WI)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more