- 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
- Henry Ford Health System (Detroit, MI)
- …to support timely and appropriate reimbursement. * Product Selection and Payer Formulary Review: Identify appropriate formulary medications, NDCs, and corresponding ... pharmacists, healthcare providers, insurance companies, and third parties to resolve payer issues, minimize claim denials, and optimize service delivery for improved… more
- J&J Family of Companies (Horsham, PA)
- …strategic thinking, and cross-functional collaboration to support market access, payer value propositions, and healthcare provider education. **You will be ... business needs + Develop a deep understanding of US payer needs and integrate insights into payer ...US payer needs and integrate insights into payer communication materials. + Champion the approval of new… more
- Guthrie (Sayre, PA)
- …skills and proficiency in analyzing complex billing problems, prepares appeals, challenges payer policies and pursues appeal turnover when necessary. 4. Works with ... train internal rejection protocols. Keeps current with coding knowledge, reimbursement policies, payer guidelines and other sources in order to ensure best practice… more
- Surgery Care Affiliates (Boise, ID)
- …cash collection metrics and goals. + Maximized facility reimbursement. + Understands each payer contract and will utilize to ensure payments received are correct. + ... can explain the Explanation of Benefits received from any payer . + Works closely with payer provider relations representatives. + Has thorough knowledge of ASC… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Under the general guidance of the Financial Services Management Team, the Payer Collection Clerk independently reviews open hospital accounts to ensure they have ... been processed correctly. It is the responsibility of the Payer Collection Clerk to contact the insurance carrier that...unpaid balance and resolve based on these findings. The Payer Collection Clerk will use independent judgment to take… more
- UTMB Health (Galveston, TX)
- …compliance with federal and state regulations. This role will oversee payer relationships, evaluate financial and operational performance of contracts, and ... and operational effectiveness. * Develop and maintain strong relationships with payer representatives to facilitate contract negotiations and dispute resolution. *… more
- Covenant Health Inc. (Knoxville, TN)
- …improve cash collections, and ensure compliance with federal, state, and payer regulations. This position collaborates closely with hospital units, medical staff, ... and integrated operations. + Monitors industry trends, regulatory changes, and payer requirements to proactively adjust strategies. + Prepares and monitors annual… more