- 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
- Option Care Health (Hudson, OH)
- …Creates documentation required to service the patient per policy and payer guidelines. + Determines estimated patient financial responsibility using insurance ... verification information and payer contracts and/or self-pay guidelines. **Supervisory Responsibilities** Does this position have supervisory responsibilities? (ie… more
- Sanofi Group (Cambridge, MA)
- …+ Deliver decision-shaping insights: Provide financial insights on GTN programs, payer /channel mix, product launches, and contract structures to support leadership ... the financial impact of pricing strategies, market access programs, and payer negotiations; translate assumptions into clear implications for profitability and… more
- St. Luke's Health System (Boise, ID)
- …expired medications within drug classes + Support New Drug Reviews, including payer coverage inquiries + Assist in finalizing System P&T agendas and meeting ... biosimilar financial modeling and preference card analysis + Supporting medication payer coverage and financial analyses + Attending monthly Business Coach meetings… more
- BrightSpring Health Services (Huntington, WV)
- …documentation within established agency guidelines + Ensures compliance with state/local/ payer requirements and that documentation reflects the care provided and ... meets company, regulatory and payer standards + Requisition and management of equipment and supplies required to increase the client's function and independence as… more
- Sanofi Group (Cambridge, MA)
- …account development. It also works cross-functionally with Sales, Medical, Training, Payer Access & Public Affairs (PA&PA), Patient Support Services (PSS), and ... integrated into key account strategies + Collaborate across marketing, medical, training, payer access & public affairs, patient support services, and analytics to… more
- AbbVie (Florham Park, NJ)
- …stakeholders (eg, Strategic Channel Account Management, Area Leads, Area Marketers, Payer Strategy, FRMs, MOSLs, AbbVie Patient Services) to share insights, address ... + Advanced degree (MBA, MPH, etc.) + In-depth knowledge of regional payer landscapes, healthcare policies, and key customer types (IDNs, VISNs, Employers). +… more
- Robert Half Accountemps (Cincinnati, OH)
- …resolve coding discrepancies. * Stay current with coding regulations, guidelines, and payer requirements to ensure compliance. * Assist in quality assurance efforts ... care. * Ability to perform medical necessity checks and ensure compliance with payer guidelines. * Excellent attention to detail and organizational skills. * Strong… more
- BrightSpring Health Services (Louisville, KY)
- …quality, Prior Authorization, Claim Overrides and customer service* Validate Admissions payer information if missing from New Admissions* Participates in Quarterly ... in conjunction with Account Management to communicate billing, Prior Authorization and Payer information with the customer, group or chain.* Review monthly interim… more
- UPMC (Pittsburgh, PA)
- …for closing accounts. Responsible for account balances according to their respective payer when applicable, and for timely and accurate billing in accordance with ... + Verify accuracy of payment posting and reimbursement. + Work with appropriate payer and/or department to resolve any payment discrepancies. + Ability to understand… more