- 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
- Option Care Health (Chicago, IL)
- …enterprise objectives + Within their assigned team, partners with operations and payer counterparts to build regional strategic market plans to increase market ... an expert in local market dynamics for their assigned team (including payer issues, state and government regulations, provider payment issues, etc.) and clinically… more
- Tidelands Health (Myrtle Beach, SC)
- …clean claim including special billing procedures that may be defined by a payer or contract + Review and resolve clearinghouse rejection errors, denials, and charge ... Level II, and ICD-10-CM medical codes and modifiers based on coding and payer guidelines. + Maintain a solid understanding of anatomy, physiology, and medical… more
- Trinity Health (Ann Arbor, MI)
- …that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to hospital users, ... benefits. Responsible for analyzing, processing & editing for correctness based on payer guidelines. Resolves items & ensures claims are billed accurately. Processes… more
- Community Health Systems (La Follette, TN)
- …+ Prepares and submits Medicare claims in accordance with billing guidelines and payer requirements. + Validates patient coverage and benefits using tools such as ... Common Working File (CWF), payer portals, and internal systems. + Coordinates with admissions and clinical teams to ensure complete documentation and accurate… more
- Albany Medical Center (Albany, NY)
- …plus. + Proficiency in office software including Excel and Word. + Proficiency utilizing payer websites. + Ability to work in a team environment. + Ability to ... interprets information to efficiently reconcile accounts. + Review and understand payer policy guidelines regarding billing. + Follow internal policies and… more
- Chiesi (CA)
- …This individual Will play a critical role in executing corporate payer strategy by developing strategic relationships, along with securing formulary and/or ... Work collaboratively with Sales and Marketing to effectively maximize current payer scenarios. Negotiate and execute formulary contracts where applicable, within the… more
- Baylor Scott & White Health (Dallas, TX)
- …charges, ensuring that services are compliant with federal, state, private payer , and other applicable legal and regulatory requirements. He/she is responsible ... charge edits to validate the accuracy of information and compliance with payer requirements. Exercise independent judgment in best practice for charging edit… more
- Specialty Rx, Inc. (Columbus, OH)
- …Support* Assist pharmacy sites in preparing for insurance audits and payer reviews* Provide documentation, reports, and operational support to meet federal, ... state, and payer compliance requirements* Apply for Emergency Kit (E-Kit) licenses for new facility starts and maintain oversight of all active E-Kit licenses… more