- AdventHealth (Parker, CO)
- …benefit is achieved or according to standards of practice and payer guidelines. Participates in practice changes resulting from performance improvement activities ... and supports departmental quality standards and initiatives. Participates in practice changes resulting from performance improvement activities and supports departmental quality standards and initiatives. Oversees the care provided by physical therapist… more
- PeaceHealth (Vancouver, WA)
- …on **concurrent and retrospective UM reviews** , leveraging clinical expertise, payer policy knowledge, and technology tools to guide patient status determinations ... and promote appropriate utilization of hospital resources. You'll work fully remote*, with PeaceHealth-provided computer equipment-empowered by a collaborative team, supportive leadership, and a strong organizational commitment to diversity, cultural humility,… more
- Evolent (Lansing, MI)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... + Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs + Exceptional analytical and communication skills with the ability to identify and translate insights from… more
- AdventHealth (Tampa, FL)
- …when maximum benefit is achieved or according to standards of practice and payer guidelines. + Charges patients accurately, timely, and legibly. **The expertise and ... experiences you'll need to succeed:** **QUALIFICATION REQUIREMENTS:** Master'sBasic Life Support - CPR Cert (BLS) - Accredited Issuing Body, Occupational Therapist (OT) - EV Accredited Issuing Body, Occupational Therapist - Temporary - Accredited Issuing Body… more
- CVS Health (MI)
- …to integrate data and reporting effectively. + Analyze regional and payer specific performance against external benchmarks to identify opportunities for improvement ... + Lead team to leverage reporting/data to monitor performance against financial, clinical, cost and efficiency targets + Perform complex financial assessments to support decision-making and identify areas for improvement and efficiencies. + Advocate for and… more
- CVS Health (FL)
- …in this role, this person will utilize home infusion software, Microsoft Excel, payer portals, and other systems, as well as their critical thinking skills, to ... ensure a high quality of performance. This person will also need analytical skills and verbal and written communication skills, in order to effectively communicate with internal staff and external client personnel via telephone and email. **Required… more
- Evolent (Lansing, MI)
- …5 years of professional experience in claims-based healthcare analytics with a payer , provider, vendor, managed care, or related healthcare consulting entity + ... Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service + Previous Experience with healthcare reimbursement methodologies and calculations such as Fee for Service,… more
- Elevance Health (Granite Falls, NC)
- …(DSS), service providers, and other stakeholders preferred. + Experience working in payer space directly with providers preferred. Please be advised that Elevance ... Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is… more
- AdventHealth (Orlando, FL)
- …applicable codes in accordance with prescribed rules, coding policy, payer specifications, and official guidelines. Evaluates and optimizes various diagnostic ... options in accordance with standard rules, official coding guidelines, regulatory agencies, and approved policies. Verifies assigned codes and ensures diagnostic and procedure codes are supported by the physician's clinical documentation. Communicates… more
- AdventHealth (Daytona Beach, FL)
- …service, documenting all patient and insurance representative conversations, including payer decisions and payment arrangements. Attends department meetings and ... promotes positive dialogue within the team. Provides coverage for PBX (Switchboard) as needed, including answering phones and transferring calls. Performs cashiering functions such as collections and cash reconciliation accurately. Other duties as assigned.… more