- Genesis Healthcare (PA)
- …the territory operations staff. Included in these activities are researching payer credentialing requirements, the submission of completed payer applications ... database consistent with NCQA standards. 5. Handles correspondence with payer including updates, mailings of applications, and completed executed agreements.… more
- Norstella (Lincoln, NE)
- …etc.) across multiple brands and Market Access functions (Insights & Analytics, Payer Marketing, Field Teams, Contracting/Rebating, etc.). CSMs are the face of MMIT ... Access domain expertise (deep understanding of current and future payer trends; intimate knowledge of Payer , PBM,...and future payer trends; intimate knowledge of Payer , PBM, and IDN organization structures and offerings; understands… more
- Robert Half Accountemps (Minneapolis, MN)
- …policies and procedures to ensure compliance with healthcare regulations and payer requirements. * Analyze and monitor key performance indicators (KPIs) such ... and quality assurance checks to ensure compliance with federal, state, and payer regulations. * Implement strategies to minimize errors and mitigate financial risks.… more
- Robert Half Finance & Accounting (Vancouver, WA)
- …days, adhering to productivity standards. * Analyze denial and reimbursement trends by payer , type, or coding issue to identify root causes and escalate concerns as ... needed. * Communicate effectively with payer representatives to address large-scale denial or reimbursement issues....and enrollment processes. * Ability to analyze and interpret payer trends and denial reasons. * Proficiency in preparing… more
- Cognizant (Long Beach, CA)
- …of Pega applications driving efficiency and value for our clients in the Payer domain. **Responsibilities** + Lead the design and development of Pega applications ... capabilities. + Work closely with domain experts in the Payer sector to tailor solutions that meet specific industry...project execution is a plus. + Experience in the Payer domain is mandatory with Provider domain experience being… 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
- Aveanna Healthcare (Atlanta, GA)
- …timely. This includes billing for all primary, secondary, tertiary or any other payer for all unbilled accounts including any and all guarantors for services ... manager, supervisor, and branch location personnel informed of any significant billing payer or processing issues. Submits adjustments in an accurate and timely… more
- UNC Health Care (Hillsborough, NC)
- …care plans, tasks or interventions, care transitions, delegated work, and payer communication. The Care Manager works collaboratively with healthcare providers, ... management of patients' care as applicable per patient population. 7. Payer Communication: a. Collaborate with payers, insurance companies, and utilization… more
- Caris Life Sciences (Irving, TX)
- …requests, and apply acquired knowledge of Medicare, Medicaid, and other Third-Party Payer requirements **Job Responsibilities** + Adheres to all company policies and ... eligibility to ensure claims are billed accurately and in accordance to payer guidelines. + Ensures timely and accurate insurance authorizations are in place… more
- J&J Family of Companies (Cherry Hill, NJ)
- …product(s) to remain viable, updating practices on key private and public payer changes that impact infusion process, ensure staff in infusion clinics have ... territory's accounts and JJIM staff regarding local, regional and national payer policies; reimbursement regulations and processes (ie, eligibility and benefit… more