- Arkansas Children's (Little Rock, AR)
- …are complete and accurate and have any required attachments before being filed to payer (clean claim). 2. Expedites proper adjudication of claims by payer to ... saving children and making their lives better."_ Michael - Business Operations Manager "Arkansas Children's Hospital is a prestigious institution that cares for… more
- AmeriHealth Caritas (West Chester, PA)
- …are met + Ensure compliance with all relevant state and federal health payer regulations, payer policies, and contractual agreements and maintain accuracy and ... development of usage and user access policies and procedures + Provide input to manager on staff performance relating to technology but does not prepare or deliver… more
- Penn Medicine (Philadelphia, PA)
- …+ Responsible for rejections, edits, and accounts receivable for specific payer group(s) work queues as assigned. + Initiates and coordinates follow-up ... and days in A/R for each type of insurance payer assigned. * Demonstrates success in completing target level...progress. + Follows workload priority as assigned by the Manager on a daily basis to maximize efficiency. +… more
- University of Rochester (Rochester, NY)
- …compliance with State and Federal Regulations, accreditation standards and third-party payer requirements for the purpose of minimizing risk and exposure. This ... business, market growth, service development and payor/PBM strategies. + Participates with payer contracting leaders of the health system in the evaluation and… more
- Houston Methodist (Houston, TX)
- …nationally recognized acute care indicators and criteria as approved by medical staff, payer guidelines, CMS, and other state agencies. In addition to performing the ... of care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. The URSN position… more
- Point32Health (Canton, MA)
- …our Point32Health market. This role requires a deep understanding of healthcare payer systems, digital product management, and user experience design, with the ... **Skill Requirements** + Strong experience within the health insurance or healthcare payer space. + Deep knowledge of health plan operations, member and provider… more
- AnMed Health (Anderson, SC)
- …correct destination as defined by the requirements in the facility's various Third-Party Payer contracts. + Resolve issues with payer sources, reporting any ... ongoing problems to the appropriate manager or supervisor. Qualifications + High school diploma or GED. + Good communication skills, both written and verbal. + Prior… more
- Cedars-Sinai (Beverly Hills, CA)
- …pharmacy analytics and reporting. Under the direction of the Pharmacy Manager , the coordinator applies data-driven methodologies to improve specialty pharmacy ... operations and monitor payer formulary and access changes. This position ensures compliance...quality and safety outcomes, engaging with external stakeholders regarding payer and limited distribution drug access, and managing data… more
- Rush University Medical Center (Oak Park, IL)
- …functions consistent with Federal, State and Local regulatory agencies and payer requirements, and organizational policies and procedures, including HIPAA privacy ... process which is a required communication with the patient's payer to ensure that the payment for patient's inpatient...13. Other duties as needed and assigned by the supervisor/ manager . Rush is an equal opportunity employer. We evaluate… more
- Mental Health Association of SCK (Wichita, KS)
- …ethics and professional development. + Works with Senior Director/Billing Manager /Clinical Coordinator to ensure effective and efficient front office processes. ... and philosophy of the program. + Ensures compliance with payer systems, including utilization review functions. + Completes quality...license. Must be eligible for approval of 3rd party payer systems and apply for a variety of insurance… more