- 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 (Lees Summit, MO)
- …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
- 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
- AdventHealth (Altamonte Springs, FL)
- …applications are secured and stored for future use and submits to contracted payer plans for ancillary sites. Assists in maintaining a complete database of all ... to ensure contracts are in place prior to sending applications to payer . Supports ancillary contracting and operation services by auditing and analyzing data,… more
- UPMC (Pittsburgh, PA)
- …+ Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies. + Identify root cause ... and medical terminology is preferred. + Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment… more
- CVS Health (Monroeville, PA)
- …with the dispensing medication and using the bill method required by the payer . + Transmit or submit claims (paper/electronic) to insurance payors for reimbursement. ... systems, including all. + billing reports, queues, or diversions according to payer and company policy guidelines + Research and respond to insurance companies… more
- Sanofi Group (Morristown, NJ)
- …experience in data science or advanced analytics within Pharmaceutical or Payer organizations5+ years of hands-on experience building and deploying predictive models ... and formulary datasets + Working knowledge of the US healthcare system, payer landscape, and regulatory environment + Familiarity with healthcare data standards (eg,… more
- Houston Methodist (The Woodlands, TX)
- …volume + Ability to review clinical documentation for Medical Necessity and payer requirements + Working knowledge of CPT, International Classification of Diseases ... resources to initiate and verify authorization needed for prompt submission. Notifies the payer of the patient's admission or procedure in a timely manner, to ensure… more
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