- Tidelands Health (Myrtle Beach, SC)
- …clean claim including special billing procedures that may be defined by a payer or contract. + Review and resolve account checks, clearinghouse rejection errors, ... + Analyze clinical data and interpret information. + Have knowledge of payer guidelines related to MUE, Medical Necessity, LCD/NCD requirements and HIPAA/Compliance… more
- Novo Nordisk (Norwich, CT)
- …current co-promotion partners. Internally, the CMCS I reports to the District Business Manager of the specific sales territory. The CMCS I also interacts and ... basis with territory level impact + Demonstrates understanding of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer … more
- Albany Medical Center (Albany, NY)
- …be able to work in conjunction with Nursing Supervision and Patient Triage Manager for accurate bed assignment for inpatient and observation patients. In addition, ... registration + Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility + Responsible to… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …Strategy will own specific accounts and business segments (either IDNs, GPOs, Payer ) for the purpose of strategy development. The Director, Contract Strategy is ... a proven leader supporting the development, refinement of Payer /GPO contracting strategy for the Ophthalmology portfolio, including traditional rebate agreements and… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …fax lines and portals. + Contact the client and family, liaison and/or Program Manager , referral source, and branch staff within one (1) hour of the referral. + ... for admission to Hospice care according to Medicare, Medicaid, and third-party payer guidelines. + Maintain discretion, as the position could be exposed to… more
- Lilly (Indianapolis, IN)
- …and Value Proposition that addresses key customer needs (patient, provider, and payer ); the product lifecycle plan, clinical strategies, development plans and study ... by working closely with business unit, brand team, clinical plans manager /project management associates and other cross-functional management during the development… more
- Mount Sinai Health System (New York, NY)
- …direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access ... with the prior authorization process preferred. Working knowledge of third party payer plans and how they are processed, of medication reimbursement, including the… more
- Rush University Medical Center (Chicago, IL)
- …the patient's clinical background and clinical information that is required for the payer to issue a referral or an authorization. Per referral guidelines, provide ... appropriate clinical information to the payer . 4. Contact review organizations and insurance companies to...15. Other duties as needed and assigned by the supervisor/ manager . Rush is an equal opportunity employer. We evaluate… more
- Kaniksu Community Health (Sandpoint, ID)
- …+ Monitors insurance claims for timely reimbursement + Ensure compliance with payer policies, HIPAA regulations, and internal billing procedures. + Maintain current ... (including CPT, ICD-10 and HCPCS codes), and compliance regulations including payer policies and HIPAA regulations. + Collaborate with providers, coding staff,… more
- Saratoga Hospital (Saratoga Springs, NY)
- …within Patient Engagement Center (PEC), under the direct supervision of the Manager . The Referral and Authorization Specialist (RAS) is responsible for scheduling ... and resource/provider schedules. Makes daily work assignments for teams. + Assists Manager in providing direct support to assigned team members, supporting team… more
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