- Robert Half Technology (Cincinnati, OH)
- …environments. * Healthcare industry experience is preferred. * Familiarity with payer systems is desirable. * Local candidates are preferred, though remote ... candidates will be considered. Technology Doesn't Change the World, People Do.(R) Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract,… more
- Centene Corporation (Austin, TX)
- …activities to ensure compliance with current state, federal, and third-party payer regulations + Provides feedback to leadership on opportunities to improve ... and enhance care and quality delivery for members in a cost-effective manner + Other duties or responsibilities as assigned by people leader to meet business needs + Performs other duties as assigned + Complies with all policies and standards… more
- Beth Israel Lahey Health (Woburn, MA)
- …their homes and communities in accordance with home care regulations and payer guidelines. **More Specifically** : + Coordinate care for assigned patient caseload ... including but not limited to: delegating to and supervising of PTA staff (if applicable), processing patient condition change visits, and completing OASIS time points. + Complete and document an initial assessment of patient and family to determine home care… more
- Queen's Health System (Honolulu, HI)
- …specific to government-funded health care program and third-party payer reimbursement. o Proficiency with computer-based hospital billing/records applications ... and Microsoft Office applications, ie Word and Excel. * Prior experience with Epic systems preferred. Equal Opportunity Employer/Disability/Vet more
- Centene Corporation (Spring Hill, FL)
- …care management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform home and/or other site visits to assess ... member's needs and collaborate with healthcare providers and partners + Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare… more
- Cognizant (Long Beach, CA)
- …understanding of Pega Process Modeling and Pega Process Analysis + Domain expertise in Payer ; experience in Provider is a plus **These will help you stand out** + ... Hands-on experience with Pega Mobility to enable mobile access to applications + Familiarity with Pega Express for rapid application development and deployment + Demonstrated success in managing Pega Case Management processes + Experience implementing decision… more
- Centene Corporation (Frankfort, KY)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides education to members and their families on ... procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs + Provides feedback to leadership on opportunities to improve and enhance care and quality… more
- Insight Global (Syracuse, NY)
- …local laws and regulations. Monitors billing compliance with all third-party payer regulations. Maintains confidentiality in compliance with HIPAA regulations and ... ensures that department remains compliant with all relevant regulations. Completes other duties as needed and assigned. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every… more
- Albany Medical Center (Albany, NY)
- …experience with denial prevention including but not limited to third party payer contractual agreements and Practice and Hospital Billing Regulations; review billing ... edits for long term approach for resolution at time of scheduling. + Demonstrate critical thinking and ability for successful service recovery. + Excellent attention to detail and ensuring all procedures are followed for best practice pre-service (revenue… more
- Bon Secours Mercy Health (VA)
- …Contract work including but not limited to: direct patient care, managing payer relationships or health systems outcomes (required) + Working knowledge and ... familiarization with process improvement models (such asPDSA andA3) (preferred) + Experience in value-based arrangements, clinical reporting packages (such as Milliman or Tableau) (preferred) **Working Conditions** + Periods of high stress and fluctuating… more