- Avera (Pierre, SD)
- …insurance information and authorization details to optimize reimbursement from both the payer and patient. The Specialist must maintain strong working knowledge of ... able to understand and interpret patient liability and benefits for all payer types including copays, co-insurance, and out-of-pocket responsibilities in order to… more
- Beth Israel Lahey Health (Exeter, NH)
- …eligibility for visit, using various online tools and by contacting the payer directly. (essential) 2. Identifies payer medical necessity determination before ... 3. Determines authorization requirement and, when necessary, obtains authorization from payer by utilizing payer specific protocols. Requests and coordinates… more
- Johns Hopkins University (Baltimore, MD)
- …all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. Works closely with departmental management and coordinates with ... for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. + Works closely with Office of Compliance for Professional… more
- Johns Hopkins University (Middle River, MD)
- …all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. Works closely with departmental management and coordinates with ... for all aspects of coding, quality assurance, and compliance with Federal payer documentation guidelines. + Works closely the Office of Billing Quality Assurance… more
- St. Luke's Health System (Boise, ID)
- …of detailed financial models, analyses and reports to support third party payer contract negotiations and optimization of the performance of existing third-party ... payer relationships. Responsible for the development of the necessary...in various departments on new or amended third party payer contract rates, terms, and conditions. Responsible for the… more
- Guthrie (Sayre, PA)
- …on unresponded claims. Works denied claims by following correct coding and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing ... ensure accurate and timely claim submission to individual payers. Reports possible payer or submission issues. 2. Works closely with a Denial Resolution Specialist… more
- Johns Hopkins University (Baltimore, MD)
- …all aspects of coding, quality assurance, and compliance with federal payer documentation guidelines. Works closely with department management and coordinates with ... billing staff, and others to ensure compliance with specific payer regulations and CPA policies and procedures. + Supports...special billing procedures that may be defined by a payer or contract. + Maintains a system of billing… more
- Regeneron Pharmaceuticals (Seattle, WA)
- …manage product concerns. + Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize basket ... healthcare provider offices with coding, billing, and submissions in range of payer environments. Well versed with implementing and executing Medicare, Medicaid, and… more
- Bausch + Lomb (Atlanta, GA)
- …+ Subject matter expert on Bausch + Lombs patient support programs, payer utilization management, access issue resolution, financial assistance and Company approved ... marketing plans. + Establish and maintain knowledge on the local and national payer landscape. + Manage daily activities and provide support for appropriate patient… more
- Community Health Systems (Franklin, TN)
- …hospital resource utilization, reduce readmissions, and maintain compliance with payer requirements. **Essential Functions** + Performs admission and continued stay ... to obtain necessary documentation for medical necessity, discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's… more
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