- University of Michigan (Ann Arbor, MI)
- …Chair, or Service Chief when appropriate Regulatory Readiness: + Coordinates delegated payer audits for all contracted health plans + Participation in TJC, CMS, ... current vendor contracts for MSS + MSS lead for delegated facility and payer credentialing contract development and review Travel + Approximately 10% travel for… more
- UCLA Health (Los Angeles, CA)
- …resolving inquiries. + Calculate net revenue, contractual allowances, and third-party payer expenses. + Analyze hospital accounts receivable models and other ... a related field. + Advanced knowledge of Medicare, Medi-Cal, and third-party payer reimbursement systems and regulations. + Expertise in financial modeling, data… more
- Option Care Health (Houston, TX)
- …enterprise objectives + Within their assigned team, partners with operations and payer counterparts to build regional strategic market plans to increase market ... an expert in local market dynamics for their assigned team (including payer issues, state and government regulations, provider payment issues, etc.) and clinically… more
- TEKsystems (Chesapeake, VA)
- …originate from our hospital system. + Submit and manage claims across multiple payer portals, including Medicare (primary payer for most patients). + Maintain ... a manageable monthly patient volume of ~100 patients, ensuring timely and accurate claim processing. + Take complete ownership of billing operations, including: + Claim submission + Payment posting + Denial management + Follow‑up and resolution activity… more
- Corewell Health (Grand Rapids, MI)
- …in the areas of software modification, upgrades and third party payer requirement changes by researching, analyzing, identifying and prioritizing user needs ... of current Medicare, Medicaid, Blue Cross, Commercial Insurance third party payer policy changes, trends, technology, and the processes surrounding the applications… more
- University of Michigan (Ann Arbor, MI)
- …Project, or other claims data sources required + Experience working with multi- payer claims data preferred + Working knowledge of hospital pay-for-performance / ... payer incentive reimbursement programs preferred + Knowledge or experience working with the BCBSM Collaborative Quality Initiatives preferred **Modes of Work**… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …leader and strategist who is passionate and skilled at uncovering HCP, payer , patient and competitive insights to shape product strategies and investment decisions ... + Generate Strategic Insights: Deliver actionable insights from HCP, patient, payer , and competitive data to guide brand, access, and investment strategies.… more
- Henry Ford Health System (Troy, MI)
- …9. Obtains, verifies through internal and external resources, adds insurance, and confirms payer filing order. 10. Analyzes and processes refunds as a result of ... Effectively communicates any patient balance issue with internal and external payer , vendors, or contractors. 14. Maintains strict confidentially standards for… more
- Rush University Medical Center (Chicago, IL)
- …adjustments, refunds, and claim corrections resulting from the multitude of claims and payer edits as well as notifying denial management of audits. Exemplifies the ... contract allowable payment schedule. 2. Follow up on claims with the appropriate payer for reimbursement. 3. Work directly with various departments to insure the… more
- Walgreens (Ironton, MO)
- …pharmacy department employees are trained in all required functions regarding payer and pharmaceutical contractual requirements (adverse event reporting, data and ... pharmacy department employees are trained on all required functions regarding payer and pharmaceutical contractual requirements (Adverse event reporting, data and… more
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