- University of Utah Health (Salt Lake City, UT)
- … disputes. + Implements process improvements for admissions, billing, third party payer relations , compliance and collections to ensure that the financial ... **- Analytical (data trends) and reporting.** **- Understanding of payer contracts and reimbursements.** _As a patient-focused organization, University of… more
- Northeast Family Services (Brooklyn, NY)
- …and innovative behavioral-health models. + Support contract negotiations and onboarding of new payer or referral partnerships. Payer Relations & Network ... to drive expansion in new and existing markets, strengthen payer and referral relationships, develop innovative service offerings, and...Strategy + Assess reimbursement environments and payer trends across states to inform growth strategy. +… more
- Nuvance Health (Danbury, CT)
- …organizational and record keeping skills. Company: Nuvance Health Org Unit: 1784 Department: Payer Relations Exempt: No Salary Range: $20.86 - $38.73 Hourly We ... that provider rosters and locations are current. Responsible for reporting payer credentialing status to WCHN management. Makes suggestions for enhancements/changes… more
- Community Health Systems (Franklin, TN)
- …in care management preferred + 1-2 years of experience in utilization management, payer relations , or hospital revenue cycle preferred **Knowledge, Skills and ... hospital resource utilization, reduce readmissions, and maintain compliance with payer requirements. **Essential Functions** + Performs admission and continued stay… more
- Humana (Phoenix, AZ)
- …knowledge of CMS compliance audits and state regulatory processes. + Familiarity with payer relations and contract management. + Strong data analysis and ... the DSNP plans. This position ensures accurate program tracking, supports payer relationships, facilitates training and communication across internal and external… more
- HCA Healthcare (Nashville, TN)
- …support to various teams, including payer contracting and analytical teams, payer relations , managed care, legal support, and service line leaders. Your ... best practices when collaborating with customers and peers. + Assist the Payor Relations Managed Care teams and Managed Care Legal teams in proactively preparing for… more
- HCA Healthcare (Hendersonville, TN)
- …member of hospital's peer review committees as requested. Business Development and Payer Relations : + Evaluates clinical appropriateness of new medical ... services to facility-level physician credentialing, business development, and provider relations in contracting issues. + Provides medical consultation on… more
- Surgery Care Affiliates (Boise, ID)
- …Explanation of Benefits received from any payer . + Works closely with payer provider relations representatives. + Has thorough knowledge of ASC Allowable ... cash collection metrics and goals. + Maximized facility reimbursement. + Understands each payer contract and will utilize to ensure payments received are correct. +… more
- Omaha Children's Hospital (Omaha, NE)
- …+ In-depth knowledge of Revenue Cycle Operations including third-party reimbursement, payer relations , claims adjudication, contractual claims processes, and ... resolution and escalation of payment issues or discrepancies in collaboration with payer reps, internal departments, and vendors. * Stay informed of CMS, Medicaid,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …offers an opportunity to build expertise in revenue cycle operations and payer relations while ensuring compliance with organizational and regulatory standards. ... Contract Variance Analyst provides foundational support in managing appeals related to payer contract variances and fatal denials. This role is responsible for… more
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