- Truman Medical Centers (Kansas City, MO)
- …+ Awareness of trends in utilization review and governmental third party payer reimbursement policies, standards and procedures. + Knowledge of standard problem ... solving, management information systems and governmental and third party payer billing information requirements. + Written and verbal communication skills to… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Accounting, Revenue Cycle, External Affairs, Business Initiatives & Strategy, Payer Contracting. ▪ Experience in overseeing complex regulatory/compliance audits. ▪ ... unique to the industry. **SUPERVISORY RESPONSIBILITIES:** Direct Reports ▪ Sr Director Payer Contracting and Performance ▪ Sr Director Finance Administration ▪ VP… more
- R1 RCM (Chicago, IL)
- …R1's reach and data give your work uncommon leverage - 180M+ annual payer transactions, 550M patient encounters, 20K proprietary payment algorithms, and 1.2B annual ... of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare… more
- Rush University Medical Center (Chicago, IL)
- …compliant coding/billing practices. * Extensive knowledge of federal, state and payer specific regulations and policies pertaining to documentation, coding and ... in in compliance investigations as needed for RUMC and ROPH including payer contacts, OIG/RAC correspondence, summary documentation of status and action taken,… more
- Rush University Medical Center (Chicago, IL)
- …manual claims, verifying claims with providers, and submitting claims bundle to the payer . Follow-up with payer for late payments. Verify payment(s) with RUMC ... Finance, calculate distribution, and balance all supporting schedules before distributing schedules to RUMC Finance for payment distribution. 5. Ability to interpret contract terminology and apply the specific terms by contract in the calculation of expected… more
- St. Luke's University Health Network (Allentown, PA)
- …accounts, as well as to ensure compliance with all Federal, state, insurance payer and St. Luke's Network policies. + Analyzes denied claims and investigates the ... maximum reimbursement. + Statuses claims resolution, appeals and corrected claims via payer websites when possible. PHYSICAL AND SENSORY REQUIREMENTS: Sitting up to… more
- Dignity Health (Santa Maria, CA)
- …notifies patient that an ABN will need to be signed. Identifies payer requirements for medical necessity. 5. Verifies patient liabilities with payers, calculates ... with other departments, as needed, to ensure proper compliance with third party payer requirements. + Other Duties 1. Understands and follows the Cashier policy and… more
- Carle Health (Champaign, IL)
- …as an expert resource for escalated account activities for multiple payer product lines. Responsible for downloading, reviewing, and interpreting payment remittance ... Facilitates maximization of revenue by ensuring correct coding initiative and payer specific guidelines are applied appropriately and claims are appealed as… more
- BrightSpring Health Services (O Fallon, IL)
- …leadership + Acts as a resource and has a working knowledge of payer requirements relating to the provision of care and documentation guidelines + Completes ... performance related to patient care + Ensures compliance with regulatory, payer and company requirements + Facilitates the development of performance improvement… more
- Whidbey General Hospital (Coupeville, WA)
- …professional affiliates. The PFS Representative follows all federal, state and payer specific regulations and policies pertaining to documentation and billing ... on messages from Medicare and Tricare. + Maintains insurance notebook on different payer requirements. + Acts as an insurance resource to other departments and… more