- BrightSpring Health Services (San Antonio, TX)
- …clinical outcome tools based on diagnosis.. Monitors patient, family, physician and payer /case manager, referral source satisfaction with the program on a regular ... and family members.. Communicates regularly with patient, family/ care partner, payer /case manager and physician regarding patient progress and any important issues… more
- BJC HealthCare (St. Louis, MO)
- …**Responsibilities** + Responsible for all payers and having a clear understanding of payer contract language and BJC's appeal rights. Works in EPIC to identify ... partners among BJC to aid in explaining trends identified that are causing payer denials. Collaborates to develop best practices procedures to prevent denials. +… more
- Growth Ortho (Sioux Falls, SD)
- …on outstanding A/R, including unpaid, underpaid, and denied claims across all payer types. Analyze EOBs and prepare effective appeals to drive resolution. Review ... collections, payment posting, and/or denial resolution workflows. Ability to analyze payer responses and draft appeals. Familiarity with patient communication and… more
- Cabinet Peaks Medical Center (Libby, MT)
- …with other departments to gather the clinical information required by the payer to authorize services. Maintains accurate records of authorizations within the EMR. ... Maintains professional ton at all times when communicating with patients, payer representatives and fellow coworkers. Performs other clerical duties assigned by… more
- St. Luke's University Health Network (Orwigsburg, PA)
- …from patients and performs accurate and timely verification of third party payer and worker's compensation. + Communication and/or updating of correct patient ... regulations. + Knowledge of complying with Federal and State law and private payer health care program requirements as well as the hospital's ethical and business… more
- Guthrie (PA)
- …and complies with billing guidelines for federal, state, and third‐party payer contracts. 10. Establishes and updates reports, departmental goals, initiatives, and ... established policies and procedures including government, insurance, and third‐party payer regulations. 10. Attends administrative meetings and participates in… more
- Huron Consulting Group (Chicago, IL)
- …experience is essential. + Demonstrated expertise in fee-for-service payer contracting and reimbursement, including Traditional ("Original") Medicare ... as well as with innovative payment models, negotiating complex payer reimbursement contracts for provider organizations, understanding reimbursement methodology… more
- Otsuka America Pharmaceutical Inc. (Juneau, AK)
- …representing OAPI with Regional Payers. This includes interacting with all assigned payer channels and customers to attain and maintain profitable access for OAPI ... representing OAPI with Regional Payers. This includes interacting with all assigned payer channels and customers to attain and maintain profitable access for OAPI… more
- Robert Half Office Team (Atlanta, GA)
- …CPT codes. * Ensure all coding practices comply with regulatory requirements, payer policies, and official guidelines. * Collaborate with healthcare professionals to ... and inpatient coding guidelines. * Familiarity with healthcare regulations and payer policies. * Ability to work collaboratively with clinical and administrative… more
- Sharp HealthCare (San Diego, CA)
- …to healthcare team.Conduct daily concurrent reviews per protocol/policy and payer request.Utilize appropriate care guideline software to identify the correct ... required (experience with MCG an asset). + An understanding and knowledge of payer eligibility and reimbursement regulations and impact on the continuum of care. +… more