- Trinity Health (Schenectady, NY)
- …regulatory and facility's corporate compliance standards + All clinical and payer required documentation is concise, pertinent, legible and in accordance with ... organizational requirements **What you will need:** + Graduate of an approved Physical Therapy program with a Bachelor of Science, Master's degree or Clinical Doctorate of physical therapy degree. + Current NYS Physical Therapy license and registration + 1… more
- Fallon Health (Worcester, MA)
- …Broad experience in managed care and /or integrated delivery systems, either payer or provider. + Significant experience in regulatory and accreditation compliance ... requirements for Medicare, Medicaid and the division of insurance support all Fallon Health Products + Experience in managing health care and support personnel, as well as managing health care personnel and external relationships. + A comprehensive knowledge… more
- CaroMont Health (Gastonia, NC)
- …of sensitive information. Must have knowledge of Medicare, Medicaid and other payer requirements related to coding and billing claims for services rendered. ... Excellent verbal and written communication skills. . Must be able to maintain the highest level of confidentiality of sensitive information. Familiar with coding software preferred. EOE AM/F/VET/DSABILITY more
- University of Rochester (Rochester, NY)
- …limited to pre-certifications, Utilization Management, Medicaid Pending, third party payer issues, and denials/appeal processes. Involves in-depth communication and ... follow-up with assigned area, Financial Assistance, Social Work, Utilization Management, Medicaid Enrollment & Outreach, patients, families, third-party payers, and governmental agencies. **ESSENTIAL FUNCTIONS** **_Customer Interactions_** + Create a… more
- OhioHealth (Marion, OH)
- …ensuring management within established parameters. Functions as a liaison to the payer to manage the post-discharge financial resources and ensure expected treatment ... process, progress and discharge plan. Monitors and ensures completeness of all assigned patients in areas of treatment plan and timely reports. Help patients coordinate care for the highest quality of life, while managing to the lowest cost. Working with… more
- BGB Group (New York, NY)
- …of services, including traditional pharmaceutical advertising, promotional medical education, payer marketing, and consulting services. Known for excellence and ... professionalism, we're hired as strategic and creative partners by our biopharmaceutical clients to drive category/brand awareness and growth. * Candidates must be located in the Tri-State area and willing to travel as needed to support client relationships.… more
- HCA Healthcare (Dallas, TX)
- …the established chain of command + Makes appropriate referrals to third party payer , disease and case management programs for recurring patients and patients with ... chronic disease states + Facilitates patient throughput with an ongoing focus on an effective care transition, quality and efficiency + Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to… more
- CareFirst (Baltimore, MD)
- …sound judgment. Strong leadership and vendor oversight skills with experience in payer , provider and industry collaboration. + Must be able to meet established ... deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer,… more
- Phoenix Home Care and Hospice (Hutchinson, KS)
- …physician's plan of treatment, individual plan of care, as authorized by client's payer source. + Observes, records and report's reaction to treatment and any ... changes in client's condition to appropriate personnel and/or physician. + Provides ongoing instruction and supervision of client, family or other health team personnel in the plan of treatment. + Participates in education programs, quality assessment… more
- Beth Israel Lahey Health (Exeter, NH)
- …funding necessary to meet established outcomes. Maintains working knowledge of payer requirements. 7. Provides supportive counseling and crisis intervention and ... advocacy to patients and families. Works in close collaboration with nurse case manager on all cases and; in particular; cases involving complex biopsychosocial / legal / financial issues to establish and review plan of care. 8. Prepares and maintains required… more
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