- Gentiva (Mooresville, NC)
- …This role plays a vital part in maintaining accurate medical records, identifying payer trends, and ensuring billing compliance across all areas of the revenue ... in home health or hospice billing, with a strong understanding of payer systems and reimbursement processes. **Key Responsibilities:** + Process assigned Medicare,… more
- J&J Family of Companies (Santa Clara, CA)
- …+ Support customers in navigating Medicare, Medicaid, and commercial payer coverage policies and prior-authorization requirements. + Provide one-on-one and ... and maintain strong relationships with OBL administrators, billing leads, and payer representatives; ensure tracking through CRM systems. + Deliver in-person and… more
- Robert Half Accountemps (Los Angeles, CA)
- …actions such as issuing a refund request or sending a dispute/appeal to the payer . * Responsible for evaluating credit balances and ensuring that refunds are issued ... to the appropriate payer in a timely and accurate manner. * Work...and refunds from payers to management. * Updates correct payer and resubmits claims to the payers. * Consistently… more
- Guthrie (Sayre, PA)
- …and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes within the health system. This role ensures ... future revenue leakage. The role demands a strong understanding of payer policies, clinical documentation, and regulatory compliance. Experience 10 years prior… more
- Penn Medicine (Philadelphia, PA)
- …all payers when requesting authorization for post-acute services. + Ensures payer and customer satisfaction through effective communication and positive customer ... informed of changes in workload. + Keeps supervisor informed of Third-Party Payer patterns and trends. + Maintains confidentiality of patient information. +… more
- Globus Medical, Inc. (Collegeville, PA)
- …Supervisor, Patient Access, the Patient Access Specialist will focus on providing payer coverage support to customers from the initial processing of received ... hotline support. The Patient Access Specialist will be responsible for providing payer coverage expertise and support regarding all phases of the prior authorization… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …claims to payers. Verify all services delivered are billed to the correct payer . Work all pre-billing/post-billing reports to ensure correct data on claims. Identify ... claim issues. Guarantee timely secondary billing submissions based on the payer requirements. Complete understanding of contract requirements of each payer… more
- 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
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