- CGI Technologies and Solutions, Inc. (Raleigh, NC)
- …enrollment solutions. This role requires a solid understanding of healthcare payer operations, strong analytical and troubleshooting skills, and the ability to ... Experience with Edifecs Enrollment Management Solution (ENR). . Healthcare payer /provider domain experience. . Understanding of enrollment, eligibility, claims,… more
- Organon & Co. (Philadelphia, PA)
- …in complex markets within complex systems required. + Strong understanding of Payer environment, reimbursement and challenges within National, Regional and local ... payer market including: government programs, managed health care and evolving health care systems. + Proven ability and success in developing physician and key… more
- Sevita (San Diego, CA)
- …general community, neighbors, and competitors and other outside organizations. 3. Payer and Government Relations: Maintains and fosters positive relationships with ... stakeholders; identifies opportunities by following industry trends and responding to payer need. 3. Efficiency: Directs program strategy to manage census, maintain… more
- Logan Health (Kalispell, MT)
- …to ensure timely billing. + Partner with the Authorization team to obtain payer authorizations and referrals. + Ensure compliance with HIPAA and all insurance ... Partners with Authorization team members to obtain authorization and referrals from payer . Completes documentation as required for coordination of care and patient… more
- Northern Light Health (Ellsworth, ME)
- …& other healthcare team members including inpatient facilities, the patient's payer , and health system administrators regarding transitions of care and facilitates ... for coordination of care services. + Maintains working knowledge of payer requirements. Develops collaborative working relationships with insurance case managers;… more
- Northern Light Health (Ellsworth, ME)
- …providers, other healthcare team members to include inpatient facilities, the patient's payer and health system administrators to transitions of care and facilitate ... for coordination of services. + Maintains a working knowledge of payer requirements. Develops collaborative working relationships with insurance case managers;… more
- University of Miami (Miami, FL)
- …resource availability, special needs, timeframes, medical necessity, and payer and contractual guidelines. Oversees and clears patient work ... pathology, laboratory, and state/ federal regulations. + Completes the Medicare Secondary Payer Questionnaire (MSPQ) at time of scheduling prior to services being… more
- Robert Half Finance & Accounting (Jackson, MI)
- …and operational decision-making + Ensure compliance with applicable accounting standards, payer requirements, grants, or contractual terms + Lead external audit and ... reimbursement, or revenue recognition models + Demonstrated experience managing multi- payer , grant-funded, cost-based, or contract-driven billing environments + Strong… more
- Rochester Regional Health (Rochester, NY)
- …timely fashion + Billing. Complete cash reconciliation daily; apply all third-party payer and patient payments to patient accounts; enter and maintain the integrity ... of all patient demographics and third party payer information in the applicable lab and billing systems EDUCATION: LICENSES / CERTIFICATIONS: PHYSICAL REQUIREMENTS:… more
- University of Rochester (Albany, NY)
- …are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve ... accurate billing. Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of… more
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