- Nelnet (Scottsbluff, NE)
- …of need: 8:00-4:30p CST Candidates pay range: $16.50/hour Responds to incoming payer /applicant phone calls and emails, resolving various issues related to their ... on their account. 5. Update demographic and additional information on payer /applicant account. 6. Contact payers/applicants regarding their accounts, when necessary,… more
- Merck (Rahway, NJ)
- …and in-line assets. Collaborate cross-functionally to shape evidence generation and payer engagement plans that support market access objectives. + **Regional and ... differences between national and regional healthcare systems. Identify emerging trends, payer policies, and regulatory changes that impact diagnostic access and… more
- UTMB Health (Galveston, TX)
- …and understanding of all state and federal laws, rules, and regulations regarding payer billing guidelines + Demonstrates a basic understanding of CPT, ICD-9, HCPCS, ... payers and/or clients for hospital and/or Professional Patient Accounts + Resolves Payer rejections from billing system daily to bill submit hospital and/or… more
- Robert Half Finance & Accounting (Bloomington, MN)
- …finance and a proven track record of managing revenue integrity and payer relations. Responsibilities: * Lead and manage accounts receivable functions, including ... plans, ensuring compliance with state and program guidelines. * Manage payer relations and negotiate contracts to optimize reimbursement. * Supervise multi-service… more
- Gentiva (Mooresville, NC)
- …reviewing clinical information requirements from Medicare, Medicaid, and commercial payer policies. This position oversees authorization and eligibility processes, ... of medical records and documentation with an emphasis on payer eligibility requirements + Compile patient medical record information...in home care or hospice + Strong knowledge of payer eligibility requirements and claims processes + Ability to… more
- Baylor Scott & White Health (Dallas, TX)
- …aligned to BSWH overall business objectives. 3. Directs all managed care payer contracting, activities, and relationships, including payer resolution processes, ... multi-faceted issues related to contract operational performance, interpretation, and payer obligations between organization and the managed care organization. 7.… more
- Northern Light Health (Brewer, ME)
- …requests - for the Provider Management Platform to process. Responsibilities: Payer Enrollment + Initiate health plan enrollment requests. This includes group, ... provider workflows to validate deliverables (completed profiles, credential files and payer enrollments) and performance metrics (TATs and SLAs). + Individual(s)… more
- Novant Health (Charlotte, NC)
- …focuses on data analysis, staff management, and resolving systemic and payer -related issues that impact financial performance. Key Responsibilities + Analyze ... + Identify root causes of systemic issues, workflow inefficiencies, and payer -related challenges impacting revenue cycle performance. + Collaborate with internal… more
- Cognizant (Jackson, MS)
- …insurance plans. + _Adjudication:_ Approve, deny, or adjust claims based on payer guidelines and policy terms. + _Compliance:_ Maintain adherence to HIPAA ... and communication skills. + Ability to interpret insurance policies and payer guidelines. + Detail-oriented with strong problem-solving abilities. _Competencies-_ +… more
- Elevance Health (Plano, TX)
- …Ability to initiate pre-determination, prior authorizations, and appeals for denials based on payer policy. + Ability to read and interpret payer contracts, and ... payer policies to effectively manage referrals and mitigate risk of accounts receivable. + Maintain knowledge of therapies serviced by Paragon, at minimum, therapy and diagnosis correlation and patient information required. + Contacts physician offices as… more
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