- 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
- AdventHealth (Altamonte Springs, FL)
- …Description:** + Collects patient clinical and demographic data and insurance or payer information, verifies payer coverage, and obtains physician orders. + ... Arranges for support services and ensures written orders for homecare are obtained or requests an RN to take verbal orders when needed. + Oversees secretarial staff to assure accurate data entry, appropriate phone answering, management of clinical records, and… more
- AdventHealth (Tampa, FL)
- …Fully In-Person Collects patient clinical and demographic data and insurance or payer information, verifies payer coverage, and obtains physician orders. ... Arranges for support services and ensures written orders for homecare are obtained or requests an RN to take verbal orders when needed. Oversees secretarial staff to assure accurate data entry, appropriate phone answering, management of clinical records, and… more
- ZOLL Medical Corporation (Pittsburgh, PA)
- …patients. + Obtains necessary documentation for continued authorization as dictated by payer , including updated clinical information or forms. + Contacts the client, ... in medical insurance verification preferred + experience working with all payer types to include Medicare, Medicaid and third-partycommercial insurance companies… more
- Houston Methodist (Houston, TX)
- …or methods to best fit the patient's situation + Knowledge of payer requirements, authorizations, and insurance terminology + Proficient understanding of medical ... computer skills and ability to learn and navigate multiple software programs and payer websites + Ability to handle detail work accurately and rapidly + Working… more
- CVS Health (CT)
- …actionable insights. + **Healthcare Data Expertise:** Apply deep knowledge of payer and provider data, including **claims, eligibility, and utilization metrics** , ... significant experience in **healthcare analytics** . + Proven expertise in ** payer -side data** (claims, eligibility, risk adjustment); provider-side experience is a… more
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