- St. Luke's University Health Network (Allentown, PA)
- …improvements + Develops and distributes profit/ loss statement by payers used for payer negotiations and tax form 990 purposes + Provides & oversees service line ... financial information for due diligence studies, fair market value analysis, and joint venture opportunities, including summarized results for executive mgmt. and recommendations + Drafts presentations and presents, as well as coordinates the presentation… more
- University of Southern California (Arcadia, CA)
- …with HIPAA, EMTALA, the Fair Debt and Collection Practices Act, Medicare Secondary Payer , and other laws and regulations that govern Patient Financial Services. + ... Must remain informed regarding all PPO, HMO, and Medicare, Medi-Cal and indigent service programs and requirements for timely processing of claims. + Offering assistance promptly, cordially, and completely + Patient care is of the utmost priority in all… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …as assigned + Keeps informed on updates to billing requirements, editing, and payer policies affecting billing + Informs supervisor of changes to billing regulations ... + Meets department productivity and qualitative standards + Works account and claim edits in the hospital billing system + Works rejections, edits and accounts in the incomplete folder in the claim scrubber system (FinThrive), consistent with the department… more
- Community Health Systems (Corsicana, TX)
- …analyzes financial reports, including accounts receivable, billing accuracy, and payer reimbursement trends, implementing corrective actions as necessary. + Ensures ... compliance with HIPAA, OSHA, and all applicable regulatory and accreditation standards, maintaining accurate documentation and reporting. + Develops, updates, and enforces clinic policies, procedures, and workflows to ensure operational consistency and… more
- Amgen (Philadelphia, PA)
- …Services, MSLs, Nurse Educators, TLLs, Field Reimbursement]. + Strong knowledge of payer policies, reimbursement processes, and managed markets is a plus; experience ... negotiating access or navigating formulary pathways is preferred for more strategic roles. + Proven ability to build strong customer relationships, educate on complex disease states, and adapt communication to diverse audiences. + Excellent interpersonal,… more
- Otsuka America Pharmaceutical Inc. (Philadelphia, PA)
- …to competitive threats and opportunities + Educates office staff on payer guidelines and reimbursement procedures to increase pull through + Effectively ... utilizes promotional materials + **Selling Skills, Engagement & Account Pull Through** + Maintains ongoing awareness of internal support team resources available throughout the ecosystem and utilizes appropriately + Applies market and industry knowledge to… more
- Lilly (Sandusky, OH)
- …grow and own business outcomes. * Navigates the ever-changing healthcare environment and payer landscape to increase understanding of accounts and be able to impact ... key stakeholders to become trusted partners. * Utilizes appropriate business insight tools, data, and analytics to identify trends, priorities, opportunities, and potential obstacles. * Implements and adopts new technologies, including the integration of AI… more
- Dignity Health (Los Angeles, CA)
- …(ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. This position is represented by CNA. **Where You'll Work** ... Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for… more
- HCR Home Care (East Syracuse, NY)
- …and cost-effectively as possible, to achieve positive patient outcomes regardless of payer . This role is also highly focused on Aide retention operates within ... the Licensed Home Care Service Agency (LHCSA). The RN Care Services Supervisor is a dedicated to participating in our Home Health Aide Training Program (HHATP) teaching new staff to be Aides. They will follow Aides from the classroom to the field so they can… more
- Cedars-Sinai (CA)
- …holding partners accountable for care quality, efficiency and adherence to payer -neutral strategies. + Facilitates regular meetings with providers to review data, ... share guidelines, and implement standardized protocols. + Recommends and implements corrective actions as needed, in collaboration with both clinical and administrative leadership. + Supports the build and implementation of annual monitoring plans and… more