- Fallon Health (Worcester, MA)
- …* 2 years' experience as a Utilization Management/Prior Authorization nurse in a managed care payer preferred. * One year experience as a case manager in a payer ... or facility setting highly preferred. * Relevant experience may include but not be limited to experience working directly in the field of Home Health Care, Ambulatory Provider Setting, Rehabilitation Nursing Setting, Acute Hospital Setting. * Relevant… more
- Globus Medical, Inc. (Columbia, MD)
- …open billings in a timely manner + Identifies and reports to management any payer issues with regards to billing and collections + Reviews, analyzes, and reconciles ... various priorities in a fast-paced environment + Working knowledge of payer reimbursement guidelines and government, regulatory and company billing and compliance… more
- Community Health Systems (Knoxville, TN)
- …covered services. + Ability to interpret and apply insurance policies and payer guidelines to verify eligibility and benefits accurately. + Effective communication ... requests efficiently. + Proficiency in electronic health record (EHR) systems, payer websites, and insurance portals for eligibility verification. + Understanding of… more
- Amergis (Columbia, MD)
- …such as nursing notes, worker timecards, authorization, purchase order, and other payer requirements as appropriate + Accurately generates claims and/or invoices of ... sales and bills a variety of payer sources via mail, fax, web portal or electronic clearinghouse + Researches and follows up on unpaid accounts after expected… more
- Taiho Oncology (Syracuse, NY)
- …and business plan which consider unique characteristics of region (geography, payer landscape, customer mix, etc.). + Proactively develops, reviews, and modifies ... macro-environment. + Understanding of oncology reimbursement, including orals, and the payer customer segment. + Experience in assessing and communicating oncology… more
- Highmark Health (Erie, PA)
- …health care team treatment goals, and need for post-acute services based on payer coverage, community resources, and patient preferences, and barriers to discharge + ... appropriate level of post-acute services according to patient's needs and preference and payer coverage in collaboration with the physician and health care team +… more
- Takeda Pharmaceuticals (Boston, MA)
- …will have a deep understanding of the US healthcare system, including payer , PBM, specialty pharmacy, and distribution dynamics, and will have experience in ... OUS markets. + Deep understanding of the US healthcare system, including payer , PBM, GPO, specialty pharmacy, distributor and provider dynamics, and experience… more
- Penn Medicine (Philadelphia, PA)
- …and insurance verification and that authorization/pre-certifications are obtained per payer regulations and maintains accurate records of authorizations within the ... plans (eg, workers' compensation) + Demonstrates expert understanding of payer regulations and contracts and insurance terminology (eg, co-payments, deductibles,… more
- Sanofi Group (Denver, CO)
- …cross functional matrix field teams (including but not limited to field sales, payer account team, thought leader liaisons, patient support services) + Maintain open ... experience preferred + Significant experience and understanding of the ever-changing payer environment and its impact on patient access to products infused… more
- Logan Health (Kalispell, MT)
- …for patients according to the principles of OT, Logan Health policy and payer requirements. + Completes all required documentation in a timely manner according to ... payer guidelines (Medicare, private insurance, Medicaid) and Montana practice guidelines for occupational therapy. + Exhibits effective communication skills in… more
Recent Jobs
-
Nuclear Welder $40.82/hour
- BWXT (Euclid, OH)
-
Senior Java Analytic Developer (SWE-3)
- Leidos (Fort Meade, MD)
-
Physical Security System Administrator
- Unlimited Technologies (Albuquerque, NM)
-
Physical Therapist Assistant, Home Health
- CenterWell (Corning, NY)