- University of Rochester (Rochester, NY)
- …determine the reason the request was denied and prepares a response to the payer with necessary additional information. + If the denial management needs to involve ... or if physician-to-medical director conversation is needed for approval outside of the payer policy. + Documents all PAs in the appropriate location within the… more
- Movn Health (NY)
- …existing payer agreements. Qualifications + 5-8 years in provider relations , physician outreach, or healthcare sales, ideally in cardiology, chronic care, or ... existing accounts, drive referrals and renewals, and expand utilization under our national payer contracts. You'll own the revenue and net retention metrics for your… more
- Abbott (Abbott Park, IL)
- …and model scenarios for impacts/risks/opportunities of proposed government legislation, payer and environmental changes + Work cross functionally with Forecasting, ... Finance, and Commercial Teams to project and monitoring payer mix and net prices + Develop financial modeling, including pricing model upkeep and improvement +… more
- Covenant Health Inc. (Knoxville, TN)
- …course of action for proper resolution. + Responsible for learning & understanding payer rules, as well as state/federal guidelines. + Responsible for prioritizing & ... guidelines, HCFA guidelines, TennCare guidelines and other Third Party Payer requirements assuring departmental compliance. + Recognizes situations, which… more
- Sevita (Columbus, OH)
- …targets. 2. Scouting: Responds to local requests for proposals to address payer needs; identifies and participates in new start development initiatives as ... appropriate; and identifies potential acquisition partners. **Stakeholder Relations :** 1. Program Stakeholders: Maintains and fosters relations with the… more
- Growth Ortho (Georgetown, KY)
- …and outcome measures to ensure compliance with professional guidelines, payer requirements, HIPAA, and state/federal regulations. . Consistently fulfill additional ... or vacant budgeted positions, to support sustainable clinic growth Physician relations , marketing, and growth . Build and maintain strong relationships with… more
- BrightSpring Health Services (San Diego, CA)
- …and maintains positive working relationships with current and potential referral and payer sources + Builds and monitors community, customer, and patient perceptions ... comprehensive working knowledge of service markets including government agencies, major payer groups, key referral sources and competitor market positioning +… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Affairs, including local, state and national regulatory, legislative and government relations . Oversees a patient-centric legislative agenda and advocacy in support ... Accounting, Revenue Cycle, External Affairs, Business Initiatives & Strategy, Payer Contracting. ▪ Experience in overseeing complex regulatory/compliance audits. ▪… more
- Rochester Regional Health (Rochester, NY)
- …data entry, and point-of-service collections, while maintaining patient relations , customer satisfaction, and hospital financial solvency. RESPONSIBILITIES: + ... insurance coverage, eligibility, and benefits; complete required Medicare and payer documentation; collect patient-pay balances; resolve registration errors; and… more
- Intermountain Health (Ogden, UT)
- …an accurate financial review along with a comprehensive analysis of patient payer specific benefits and patient liability and provides a platform for counseling ... ensure reauthorization functions are completed in a timely manner, based on individual payer requirements. + Estimate cost of service using ICD-10 or CPT codes.… more