- UCLA Health (Los Angeles, CA)
- …experience with Medi-Cal, Medicare, HMO, and PPO insurances + Experience using online payer sites with the ability to check claim status, denials, and eligibility + ... Knowledge of MS Word and MS Excel software + Knowledge of CPT, ICD-10, and HCPC codes + Must be an effective multi-tasker in order to meet daily production and quality standards UCLA Health is a world-renowned health system with four award-winning hospitals… more
- Covenant Health Inc. (Crossville, TN)
- …documentation in accordance with professional, departmental, organizational, and payer guidelines and timeframes. Maintains established targets for compliance ... with chart audits. + Meets established target for: + Quality/outcome measures + Service/patient satisfaction measures + Financial/productivity measures + Growth/patients-per-day measures + Demonstrates leadership including, but not limited to: + Supervision of… more
- HCA Healthcare (Brentwood, TN)
- …Standards + Performs research and analysis on corporate policies and federal payer rules, regulations and transmittals as directed + Logs privacy-related issues into ... the Privacy Log and ensures all information is present for appropriate reporting + Logs compliance related issues into the Compliance General Issues Log and ensures all information is present for appropriate reporting + Logs Patient Concerns, Risk… more
- ChenMed (Miami, FL)
- …business planning, process improvement, solution assessment, etc. + Analyzes and validates payer claims data. Assists markets to identify factors driving claims cost ... and estimates historical and prospective trends. + Performs actuarial analysis of CMS public information. Calculates statistical and probability forecasts and models from data. + Runs CMS risk adjustment model to calculate member level risk scores. + Provides… more
- Guthrie (Johnson City, NY)
- …a pharmacist. + Processes prescriptions via computer system, and reviews third-party payer on-line adjudication. + Receive requests from patients via phone, e-mail, ... fax, in-person, and other means + Assists in performing inventory functions including stock replenishment and removing expired/recalled medications medications from the pharmacy shelves. + Handles questions pertaining to the operations of the pharmacy that do… more
- Robert Half Accountemps (Scranton, PA)
- …outstanding balances. * Conduct trend analysis to ensure compliance with payer reimbursement agreements and resolve discrepancies. * Prepare and analyze monthly ... aging reports to support financial oversight. * Establish best practices to uphold data integrity and quality throughout the revenue cycle. * Lead staff training initiatives to promote adherence to industry standards and compliance requirements. Requirements *… more
- Logan Health (Kalispell, MT)
- …plan and social barriers to discharge; Remains mindful of registration status and payer requirements as they relate to discharge options in order to fully support ... patients and families in making informed healthcare decisions. + Explores and communicates solutions and recommendations to social barriers impacting healthcare with appropriate stakeholders Seeks input from the multidisciplinary team and remains aware of the… more
- Amgen (Grand Rapids, MN)
- …our products to medical professionals and helping them navigate the complex payer environment. We are actively searching for a **Specialty Representative or Senior ... Specialty Representative** to deliver on our commitment to serve patients. The Specialty Representative/Senior Specialty Representative acts as the primary customer contact and is responsible for implementing marketing strategy and promoting Amgen products as… more
- Morehouse School Of Medicine (Atlanta, GA)
- …to institutional policies, ICH - GCP , FDA / OHRP regulations, and payer rules. The CTO owns day-to-day operational execution (feasibility → start-up → conduct ... → close-out), implements the quality system, and executes CAPAs assigned to Operations-while policy, regulatory oversight, and final compliance authority remain with the CRC Associate Director. Minimum Qualifications Master's degree in Health Care… more
- Martin's Point Health Care (Gorham, ME)
- …workflows and contribute to improving patient population outcomes + Monitors payer quality programs. + Disseminates results of quality improvement vs. benchmarks ... Organizational Participation/Community Outreach + Encourages increased use of the health center by monitoring physician and patient satisfaction within the health center including all services, policies, and staff-customer relations. + Monitors patient… more