- Beth Israel Lahey Health (Charlestown, MA)
- …payment and denial data down to the line item detail, identifying payer and coding trends, risks, and opportunities, to implement operational or systematic ... party payers. Research, develop and maintain a solid understanding of payer requirements, including filing limit, claim processing logic, coordination of benefits… more
- BrightSpring Health Services (Nashville, TN)
- …contracting and operations teams to evaluate collection capabilities and adherence to payer contracts. + Ensure maximization of cash collections through diligent and ... provide innovative strategies and solutions. + Stay abreast of payer requirements and changes in the industry and communicate...+ Possesses the versatility required to be a leader, manager , teacher, coach, and mentor while placing high value… more
- Rochester Regional Health (Rochester, NY)
- …patient services. Under the general supervision of the Patient Access Services Manager , this position performs imperative duties including registration pre and full, ... computer system reviewing for mandatory precertification and/or other third party payer requirements + Collects complete financial information to include payer… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements * Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate * Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients * Completes all admission… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements* Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate* Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients* Completes all admission… more
- Covenant Health Inc. (Knoxville, TN)
- …medicine and urology. Position Summary: Demonstrates knowledge of Medicare and payer billing guidelines and policies. Demonstrates ability to promptly review, ... interpret and communicate current and changes to published Medicare and other payer billing guidelines/policies. The Billing Liaison must be able to answer policy… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements + Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate + Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients + Completes all admission… more
- University of Washington (Seattle, WA)
- …to reimburse the UW Medicine for services in accordance with the payer -provider contract, and works diligently toward the identification, mitigation, and prevention ... provided at the Medical Centers. **PRIMARY JOB RESPONSIBILITIES** + Document all payer communications thoroughly, and communicated payer decisions in a timely… more
- University of Utah Health (Salt Lake City, UT)
- …of all actions and information shared with care team members or third-party payer . + Alerts and discusses with physician/provider and case manager /discharge ... cost, or over/under-utilization of resources. + Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the … more
- The Cigna Group (Bloomfield, CT)
- **Senior Program Manager (Business Architect)** We are seeking a dynamic healthcare professional to drive innovation in utilization management (UM) and Electronic ... exchange and support Cigna's strategic business objectives. As Senior Program Manager (Business Architect), you will lead project work and strategic decision-making… more
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