- UNC Health Care (Rocky Mount, NC)
- …impact on AR 4. Demonstrates advanced knowledge of both commercial and governmental payer structures, and ensures changes in payer requirements are addressed in ... resolved independently. 6. Demonstrates advanced knowledge of both commercial and governmental payer structures, and ensures changes in payer requirements are… more
- Moore County Hospital District (Dumas, TX)
- …the practice act of Texas State Board of Physical Therapy, regulatory agencies, payer guidelines, and policies and procedures of the department is maintained through ... Texas State Board of Physical Therapy examiners. Compliance with regulatory agencies, payer guidelines, and the policies and procedures of MCHD and the department… more
- Nuvance Health (Danbury, CT)
- …of comprehensive appeals, ensuring accuracy, clinical validity, and adherence to payer requirements. Monitor appeal outcomes and adjust strategies as needed. * ... all relevant federal, state, and local regulations, accreditation standards, and payer requirements. Maintain up-to-date knowledge of changing healthcare policies. *… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements * Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate * Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients * Completes all admission… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …business areas (eg, health economic modeling, value communications, observational research, payer partnerships) to a high standard. How you will contribute: * ... specifications across therapeutic areas, ensuring alignment with product value and payer needs. * Collaborate with cross-functional teams to design VBA frameworks,… more
- Moore County Hospital District (Dumas, TX)
- …the practice act of Texas State Board of Physical Therapy, regulatory agencies, payer guidelines, and policies and procedures of the department is maintained through ... Texas State Board of Physical Therapy examiners. Compliance with regulatory agencies, payer guidelines, and the policies and procedures of MCHD and the department… more
- Penn Medicine (Philadelphia, PA)
- …progression, denial management, compliance with governmental and private payer regulations, and appropriate physician documentation requirements. Reporting directly ... of care recommendations * Stay current on changes in payer rules including CMS rules as it pertains to...billing for services * Provide feedback to Contracting on payer denial patterns where appropriate * Facilitate, mentor, and… more
- Bozeman Health (Bozeman, MT)
- …areas to ensure smooth operations and revenue flow. Conduct research through payer portals to identify missing remittances. Minimum Qualifications: Required + High ... Apply contractual adjustments, write-offs, and denials as needed in compliance with payer contracts and organizational policies. + Reconcile NSF checks and lost… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …hospital admissions, continued stays, and treatment plans in accordance with payer guidelines and evidence-based practice *Quality of Practice*: * Promotes quality ... * Attains and maintains current knowledge in UR/UM practices, payer requirements, clinical guidelines, and regulations affecting utilization management *Professional… more
- Fairview Health Services (St. Paul, MN)
- …coding principles, medical terminology, governmental regulations, protocols and third-party payer requirements pertaining to billing, coding, and documentation. The ... to appropriate stakeholders and report suspected or emerging trends related to payer denials. This position requires anticipating and responding to a wide variety… more
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