- Penn Medicine (Philadelphia, PA)
- …workflow, phone calls and/or email + Obtains information to complete Medicare Secondary Payer Questionnaire and other payer specific documents as required + ... for enrollment in available credit option programs. + Effectively communicates with payer to determine extent of coverage and other limitations or co-payments… more
- Rhythm Pharmaceuticals (Boston, MA)
- …IMCIVREE. The ideal candidate will have a successful track record of payer engagement and strategic account management in the commercial self-insured and/or Medicare ... self-insured plans and Medicare Part D, educating internal stakeholders on payer needs, policy shifts, and contracting opportunities. + Consistently find avenues… 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
- Excelsior Orthopaedics Group (Amherst, NY)
- …brings strong knowledge of GI endoscopy coding, ASC reimbursement guidelines, and payer regulations. Duties and Responsibilities + Demonstrate our core values of ... procedures. + Ensuring coding practice meets federal and state guidelines, payer -specific requirements, and company policies. + Communicate with providers and… more
- Trinity Health (Livonia, MI)
- …collaboration with clinical departments, Patient Business Service (PBS) center, Payer Strategies, Compliance and other revenue cycle departments to continuously ... identified revenue enhancement opportunities. Maintains an understanding of regulatory and payer changes. Special note for Physician Billing Denials Prevention -… more
- AdventHealth (Orlando, FL)
- …structure and active participation on applicable committees (ie JOC/ Payer , Revenue Cycle, Finance Committee, etc.). COMPLIANCE/REGULATORY RESPONSIBILITY: Educates, ... through data. Provides trend data of denials to assist in improving payer or care delivery behavior. OPERATING & CAPITAL BUDGET/FINANCIAL RESPONSIBILITY: Aid in… more
- Community Health Systems (Franklin, TN)
- …use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards. The Physician Coder plays a key ... provider documentation. + Ensures compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following National Correct… more
- Motion Recruitment Partners (Durham, NC)
- …in Systems Analysis + Health Care experience (prefer experience working at a payer ) + FHIR, Clinical Data Exchange and Clinical Interoperability + Experience with ... + Experience with CMS + Epic Bridges Certificate + Payer Platform Core Certificate / CAQH Core Certificate +.../ CAQH Core Certificate + JIRA **Preferred Skills:** + Payer Platform Membership Experience Badge **What you will be… more
- Guidehouse (Philadelphia, PA)
- …the development of materials and facilitating discussions as required + Develop payer strategy including value proposition, global payer archetypes, and evidence ... which include evaluating clinical literature, health economic and outcomes literature, payer access & reimbursement policies, as well as pricing dynamics +… more
- Houston Methodist (Houston, TX)
- …patients and insurance companies. + Understanding of insurance contractual agreements, payer policies, guidelines and appeals process. + Sharp analytical abilities ... and PCI compliance regulations. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Reviews third party payer work queues for complex payers and resolve accounts. + Manages… more