- Catholic Health Initiatives (Chattanooga, TN)
- …using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. + Resubmits claims with necessary information when requested ... through paper or electronic methods. + Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. + Recognizes when additional assistance is needed to resolve insurance… more
- BrightSpring Health Services (Louisville, KY)
- …phone, text, online (web) chat, or email + Ensure compliance with state/local/ payer requirements through review of documentation + Provide coaching and education ... related to the health and well-being of persons served + Participate in performance improvement activities and maintain ongoing clinical knowledge through internal/external training programs + Document above actions in Nurse's Notes or Service Delivery Log +… 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
- Boehringer Ingelheim (New Orleans, LA)
- …of which contracts will be an important part, as well as traditional Payer contracting. + Needs, issues and market conditions. Strategy Development: + Develops and ... implements strategies to optimize portfolio, including new and existing products, positioning/access in the key areas of the assigned Organized Customer(s), such as System Formulary and overall product access through pathways and GPO opportunities. + Leverages… more
- Surgery Care Affiliates (Philadelphia, PA)
- …practices to provide practice management and clinical performance support, referral and payer alignment, data analytics, and strategic capital . W hile the ... physicians themselves provide clinical leadership, market knowledge and clinical excellence to create market-leading specialty care delivery systems. T he Market Director and CFO USDH will be the financial operations lead for SCAH's US Digestive Health… more
- Penn Medicine (Philadelphia, PA)
- …patients. + Basic understanding of CPT and ICD-9 coding, third-party payer billing processes, pre-certification requirements, and the overall revenue cycle ... (Required). + Solid understanding of the purchasing cycle (quote, requisition, purchase order, invoice, payment) and experience using ordering systems (Required). We believe that the best care for our patients starts with the best care for our employees. Our… more
- Sanford Health (Rapid City, SD)
- …practices, including reimbursement of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private sources, ... as applicable. Demonstrate extensive advanced knowledge of medical principles, practices and techniques. **Qualifications** Master's or Baccalaureate degree (Associate's or Nursing Degree if training prior to 1994). Successful completion of a physician… more
- Primary Health Care (Des Moines, IA)
- …revenue cycle. Supervises the internal billing team to ensure compliance with payer , accreditation, regulatory, state and federal rules and regulations as well as ... organizational policies and procedures. Demonstrates PHC iCare values in daily work. What's Great About this Position? + Earn 5 weeks of PTO throughout your first year of employment and enjoy paid holidays as well. + Continue to develop your skills and grow… more
- Merck (North Wales, PA)
- …access in collaboration with internal teams, and provide input into clinical, payer /access, marketing and value evidence generation strategies and programs. + In ... collaboration with internal teams and external partners, design non-interventional and data synthesis studies, author study protocols, develop measurement questionnaires, case report forms, data analysis plans, final study reports, scientific presentations,… more
- Hartford HealthCare (Bridgeport, CT)
- …develops countermeasures for potential barriers to discharge. . Identifies lack of payer source and makes appropriate referrals to secure needed insurance coverage ... or providers for post-acute care needs. . Identifies opportunities to decrease length of stay, reduce readmissions and improve patient experience through work in Lean huddles and participating in interdisciplinary team meetings. . Assess patient's readiness… more