- Cognizant (Providence, RI)
- …Oracle Golden Gate and Oracle. This role requires domain experience in Membership (HC- Payer ) and proficiency in English. The position offers a hybrid work model with ... + Ensure compliance with industry standards and best practices in Membership (HC- Payer ) domain. + Troubleshoot and resolve technical issues to minimize downtime and… more
- Baylor Scott & White Health (Waco, TX)
- …on all required forms Consistently completes the Medicare Secondary Payer (MSP) questionnaire, if applicable. Verifies insurance to determine coordination ... service experience Ability to determine patients' primary, secondary, and tertiary payer sources. Knowledge of all major governmental and non-governmental payer… more
- Devereux Advanced Behavioral Health (League City, TX)
- …executing comprehensive marketing strategies to increase program visibility, build payer and referral agency relationships, and drive referrals. Additionally, the ... the admissions and utilization management team in managing inquiries, referrals, and payer processes. * Ensure a smooth and client-centered admissions experience for… more
- Amgen (Washington, DC)
- …external collaborators. **Key responsibilities include:** + Generating global-impact payer -relevant evidence, patient reported outcomes (PRO), clinical outcomes ... for Observational Research, Real-world Evidence sub-Team (RWEsT), Global Biostatistical Sciences, US Payer Marketing, Medical Value & Access. **Be part of our team**… more
- 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
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