- Calvert Memorial Hospital (Prince Frederick, MD)
- …cash on hand for facility. Supervisory position, that helps in staff development and payer issue resolution. Also serves as a department liaison. + Education : + ... codes sets pertaining to area of supervision. Maintains knowledge of all payer billing and collection rules. Ability to communicate issues effectively with all… more
- PruittHealth (Norcross, GA)
- …3. Edits claim forms, using proper data element instructions for each payer , applying principles of coordination of benefits, and ensuring that correct diagnosis, ... settled in the timeliest manner. 7. Applies knowledge of specific payer billing/payment rules, managed care contracts, reimbursement schedules, eligible provider… more
- Guthrie (Troy, PA)
- …an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification or obtaining a Case Management ... point for communication for healthcare team members, patient, provider, and payer . b) Supports development, integration, and monitoring. c) Maintains accountability… more
- Excelsior Orthopaedics Group (Amherst, NY)
- Job Summary Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented in the ... terminology required. Duties and Responsibilities + Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information… more
- Cardinal Health (Jackson, MS)
- …with federal and state regulations and laws, CMS and other third-party payer billing rules and internal documentation, coding and billing policies and procedures. ... subject matter expert and authoritative resource regarding federal, state and payer documentation, billing and coding rules and regulations, maintaining awareness of… more
- HCR Home Care (Newark, NY)
- …and cost - effectively as possible , to achieve positive patient outcomes regardless of payer . + R esponsible for the overall plan of care and the outcome of that ... one year home care experience + Knowledge of State and Federal regulations, payer guidelines + Must possess the following skills: + Excellent communication and… more
- MyFlorida (Daytona Beach, FL)
- …oversight of care plans. Ensures Ryan White services are consistently used as the payer of last resort. Updates all required information regarding payer source ... eligibility on his/her clients in the FL RW Portal, CAREWare and HMS Databases within three business days. Completes and maintains accurate documentation of all client-specific activities. Case notes, scanned documents and all required information on clients… more
- Atlantic Health System (Morristown, NJ)
- …and thorough clinical information to insurance companies and other intermediaries to secure payer authorizations and avoid denials or reduction in level of care. 2. ... to other CM team members and interdisciplinary teams regarding progress or payer issues related to continued hospitalization and post-acute service associated with… more
- NCH (Naples, FL)
- …query practice brief. * Working knowledge of federal, state, and private payer regulations as well as applicable organizational policies and procedures. * Experience ... and other required reporting programs. * In-depth knowledge of MS-DRG payer issues, documentation opportunities, coding guidelines and changes to include Coding… more
- Northwell Health (Forest Hills, NY)
- …(ALC) status In concert with attending physician.Responds to third party payer requests for concurrent clinical information providing all relevant documentation to ... 3. Ensures compliance with current state, federal and third party payer regulations.Works collaboratively with on-site reviewers to transition patients to… more
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