- Logan Health (Shelby, MT)
- …+ Maintains knowledge of: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral, ... and a list of current accepted insurance plans. + Proactively communicates issues involving customer service and process improvement opportunities to leadership. + Meets productivity, quality requirements, and takes ownership of work to ensure excellent… 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 (Carbondale, IL)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides education to members and their families on ... procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs + Provides feedback to leadership on opportunities to improve and enhance care and quality… more
- Centene Corporation (West Palm Beach, FL)
- …care management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform home and/or other site visits to assess ... member's needs and collaborate with healthcare providers and partners + Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare… more
- Centene Corporation (Topeka, KS)
- …care management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform home and/or other site visits to assess ... member's needs and collaborate with healthcare providers and partners + Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare… more
- Trinity Health (Springfield, MA)
- …utilizing appropriate scripting. + Verifies active primary and secondary third-party payer insurance coverage eligibility with the payers via prescribes format. + ... Processes calls to ensure patients are transferred to the appropriate staff member/provider in a timely manner + Schedules patient appointments based on department protocols in order to maximize provider productivity. + Accurately registers patients ensuring… more
- MyFlorida (Largo, FL)
- …functions in the Health Information System, FLAIR, DDE, and various other payer associated portals and websites. The Accountant IV incumbent is responsible for ... performing claims processing, posting payments and collection activities of the State Veterans' Homes and providing support and assistance to all billing team members in the daily accounts receivable functions to maintain the billing as follows: + Produce and… more
- J&J Family of Companies (Titusville, NJ)
- …and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the decision to start ... or stop treatment is overwhelming. J&J recognizes this, and wants to create an experience that is personalized, helpful, and hopeful. The Associate Director, Pharmacy Excellence & Innovation contributes to a team in service to our patients. Day-to-day… 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 (Denver, CO)
- …related to correspondence with the state, local, and federal agencies including third party payer and providers to ensure issues are resolved in a timely manner + ... Oversees clinical quality and process improvement initiatives related to clinical quality indicators and financial metrics + Manages data needed to identify trends and provide recommendations to senior management of process improvements within utilization… more
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