- Rush University Medical Center (Chicago, IL)
- …in home infusion reimbursement, Medicare Part B, Medicaid, and commercial payer requirements. **Responsibilities** + Prepares and submits outpatient pharmacy (home ... coding issues, payor contracts, and collection policies. + Participates in special payer projects with management staff to ensure proper reimbursement per our… more
- TEKsystems (Jacksonville, FL)
- …product and technology teams to grow our Payment Accuracy business supporting payer and provider accounts, both pre and post sales. The successful candidate ... the sales team. Pitching payment accuracy solutions and strategy to payer department leaders (claims operations, payment integrity, provider relations), provider… more
- TEKsystems (San Antonio, TX)
- …data to support the teams in missing collection/ billing gaps for each facility and payer ! There are more than 80+ tabs on the excel sheets organized by both ... facility and payer . Responsible recording rates on account on a timely basis, resolving payment variances and completing month-end close in accordance with CBO… more
- Mount Sinai Health System (New York, NY)
- …workflows, clinical appropriateness, and regulatory requirements. Provider, Vendor & Payer Relationship Management * Maintain and strengthen partnerships with ... ongoing performance updates and ad-hoc consultations. * Sustain strong payer relationships to support utilization management goals. **Preferred Provider Strategy**… more
- HCA Healthcare (Reston, VA)
- …as an active member of the interdisciplinary team. + Communicates pertinent payer needs/requirements to physician, treatment team, patient and patient's family in a ... maintains effective working relationships with patients, families, co-workers, physicians, payer representatives, hospital administration, community members, and referral sources.… more
- CommonSpirit Health (Phoenix, AZ)
- …levels of care, care progression, compliance with governmental and private payer regulations, and appropriate physician coding and documentation requirements. Under ... fast paced environment. + Current knowledge of federal, state and payer regulatory and contract requirements. + Previous Physician Advisor/Care Management or… more
- Penn Medicine (Bala Cynwyd, PA)
- …for enrollment in available credit option programs. + Effectively communicates with payer to determine extent of coverage and other limitations or co-payments ... provisions. + Maintains knowledge of and complicates with each payer 's requirements for verifying insurance and obtaining pre-authorizations/ pre-certifications. +… more
- Ochsner Health (New Orleans, LA)
- …accurate reimbursement. This role involves reviewing medical documentation, interpreting payer policies, and preparing detailed appeal letters to overturn adverse ... accurate, and persuasive appeal letters with supporting documentation. + Interpret payer guidelines, contracts, and regulatory requirements to ensure compliance. +… more
- Novo Nordisk (Denver, CO)
- …required + A thorough understanding of the formulary process across various payer channels required + Ability to work effectively in a cross-functional team ... customers and execute against challenges of a continually changing healthcare/ payer landscape required + Demonstrated excellence in leadership, strategic… more
- Select Medical (Camp Hill, PA)
- …and insurance accounts. This role requires a solid understanding of payer contracts, reimbursement terms and billing practices. The ideal candidate demonstrates ... to ensure that the request is valid and accurate in terms of payer contracts, insurance processes, coordination of benefits, claims processing and state and federal… more