- Merck (Houston, TX)
- …targeting and business analysis. + Articulates the complexities of the HIV payer environment, recognizing the role each stakeholder plays in the ability to ... and build partnerships with key stakeholders/departments. + Experience with complex payer environments, recognizing the role each stakeholder plays in the ability… more
- Wolters Kluwer (Riverwoods, IL)
- …prior authorization logic. You will collaborate with product, engineering, and payer stakeholders to deliver standards-compliant solutions that optimize clinical and ... & Compliance: Familiarity with HL7 FHIR, interoperability frameworks, and payer -provider data exchange requirements. + Leadership & Communication: Strong ability… more
- HCA Healthcare (Myrtle Beach, SC)
- …that are not paid in a timely manner. + Review EOB's, remits and payer correspondence while performing account follow-up and escalate any identified issues to the ... taken on the account. + Work with patients and guarantors resolve payer requests and discrepancies to promptly resolve pending claims. **What qualifications you… more
- Prime Healthcare (Aurora, IL)
- …be able to demonstrate understanding of and ability to interpret third party payer principles and terms and COBRA laws. Strong organizational skills required for ... + Well versed in billing and collection regulations and requirements by payer . + Knowledge of Accounts Receivable, Medicare, Medical, HMO/PPO, Commercial and W/C… more
- Medtronic (Northridge, CA)
- …more connected, compassionate world. **A Day in the Life** The Contract Analyst ( Payer Relations Analyst) plays a critical role in supporting the Managed Markets ... related to the Revenue Cycle. + Research, document, and maintain payer requirements; educate and communicate guidelines specific to Durable Medical Equipment… more
- Northwest Florida Community Hospital (Chipley, FL)
- …principles related to patient accounting, insurance reimbursement, governmental and other payer source billing, credit and collections and cashiering related to ... and practices of patient accounting, insurance reimbursement, governmental and other payer source billing, credit and collections and cashiering related to hospital… more
- Guidehouse (El Segundo, CA)
- …manage billing and follow-up of patient accounts, compliance with third party payer regulations, and work with company resources to assure ongoing improvements to ... Be Nice To Have** **:** + Understanding of healthcare revenue cycle, payer contracts and regulation affecting reimbursement for healthcare services. + Excellent… more
- HCA Healthcare (Conroe, TX)
- …are not paid in a timely manner. ** + **Review EOB's, remits and payer correspondence while performing account follow-up and escalate any identified issues to the ... taken on the account. ** + **Work with patients and guarantors resolve payer requests and discrepancies to promptly resolve pending claims. ** ** What qualifications… more
- Blue KC (Kansas City, MO)
- …rep-resenting Blue KC during regulatory surveys, audits, quality assurance reviews, payer credentialing processes, and industry forums * Develop and deliver ... accreditation readiness, and vendor management * Experience with Symplr Payer and/or other credentialing applications * Advanced proficiency in credentialing… more
- Trinity Health (Des Moines, IA)
- …and mentor to the UM staff, the UM Lead provides education on payer requirements, regulations, and standard work practices. This role involves collaboration with the ... for patients with complex diagnoses or care settings, in accordance with payer requirements. + Maintains strong relationships with insurance payers to facilitate… more
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