- Option Care Health (Columbus, OH)
- …updated knowledge of industry, regulatory and reimbursement issues and of payer requirements. Keeps AVA team abreast of key changes.Assists with roll ... year customer service preferred.Home infusion experience on the provider or payer side preferred. Basic QualificationsAbility to multi-task and support numerous… more
- Accounting Now (Tampa, FL)
- …activity to appropriate stakeholders and report suspected or emerging trends related to payer denials to Leadership. This position anticipates and responds to a wide ... with minimal direction or intervention from Leadership.Reviews account history, remit, payer history, and state requirements to determine appropriate challenge and… more
- Accounting Now (Pinellas Park, FL)
- …of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on ... payer contracts or government regulations. In addition, the medical...adjudicationResponsible for correcting, completing, and processing claims for all payer codesAnalyze and interpret that claims are accurately sent… more
- Southeast Georgia Health System (Brunswick, GA)
- …be responsible for: Coordinates concurrent and retro precertification processes. Assesses payer denials for appropriateness of appeal and initiates the appeal ... denial appeals. Maintains denial spreadsheet report-keeps it current & accurate by payer . Works congenially with Patient Financial Services department to ensure open… more
- Blanchard Valley Health System (Findlay, OH)
- …with the Denial Avoidance and Education Team to resolve A/R and payer issues, avoid timely claim consideration/filing, failed appeals, and/or increased denials & ... experience with denial management or the ability to interpret payer explanation of benefits required Knowledge of payer... payer explanation of benefits required Knowledge of payer edits, rejections, rules, and how to appropriately respond… more
- Option Care Health (Sacramento, CA)
- …the account's objectivesWorks with Area counterparts in Operations and Sales to ensure payer pull-thru of opportunities, payer messaging for field teams, conduct ... teams.Work with the marketing team in the development of tools and collateral on payer messaging for various segments, as well as support in tools and resources for… more
- Creative Financial Staffing (Mounds View, MN)
- …refund request or credit balance Identify, report and participate with resolving payer processing challenges Process payer correspondence Other duties as ... the Collections Manager and others, including one person who solely works on all of payer credit who they will be working closely with. They will also work with… more
- Accounting Now (Tampa, FL)
- …insurance claims; includes but is not limited to remit review, calling payer (s) and clinics, rebilling, navigating payer portals, and taking adjustments.Uses ... and follow appropriate policy and procedure to remediate.Navigate through various payer systems and multiple internal systems to ensure timely and accurate… more
- University Medical Center of El Paso (El Paso, TX)
- …Verifies insurances via electronic verification system or contacts the insurance payer for verification of eligibility and benefits. Ensures that any ... pre-certification/ authorization is obtained to meet the individual payer payment protocols. Able to manage multiple task with an excellent orientation to… more
- Option Care Health (Charleston, WV)
- …specialty enterprise objectivesWithin their assigned team, partners with operations and payer counterparts to build regional strategic market plans to increase ... an expert in local market dynamics for their assigned team (including payer issues, state and government regulations, provider payment issues, etc.) and clinically… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …24 hours of each visit on 100% of patients seen.Confirms primary payer on admission and ensures determination of the reimbursement arrangement. Communicates with ... payors as indicated. Completes necessary paperwork/documentation/procedures for the appropriate payer to ensure proper reimbursement in accordance with agency policy… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …Rep will be responsible for staying current with all assigned payer updates. Minimum Job QualificationsLicensure or other certifications: Educational Requirements: ... related seminars, research, meeting with insurance reps and reading all memos/ payer updates. Ensures secondary billing on accounts with secondary liability;… more
- Patient First (Glen Allen, VA)
- …received according to the payers' contract; Reviewing unprocessed claims within the payer 's timely filing limits for re-submission of claims for payment; Verifying ... established payment plans; Establishing and maintaining a working relationship with payer representatives to ensure proper claims filing and insurance payments;… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …gaps in care.Participate in workflows to support care gap closure.Utilize available databases, payer portals, and other data and analytic tools to close care gaps ... success at quality metrics.Participate and contribute to scheduled quality and payer meetings. Physical DemandsWeight Lifted: Up to 50 lbs, Occasionally 0-30%… more
- Option Care Health (Lansing, MI)
- …From $18+Responsible for the timely, accurate submission of invoices to responsible payer , of any type, for all services and products provided. Evaluates payments ... appeals to payers.Job Description: Job Responsibilities:Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …to support services billed including ICD-9/ICD10/CPT/HCSPCS and other third-party payer codes. CEQAs ensure the medical necessity of services, compliance ... annual coding updates.Evaluates and provides appropriate documentation for the third party payer CPT denials to maintain the original CPT assignment, and when… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …to verify patients pick up medications, closing care gaps.Utilize available databases, payer portals, and other data and analytic tools to assess patient ... management provided by payers as needed.Participate in quality and payer meetings.Participate in staff meetings, in-services, and other program-specific tasks… more
- All Ways Caring Homecare (Baxley, GA)
- …meetings, in-services and other meetings as requestedEnsures compliance with state/local/ payer requirements and that documentation reflects the care provided and ... meets company, regulatory and payer standardsEnsures the ordering, reviewing, monitoring, discontinuation and, if necessary, the disposal of medications as… more
- Option Care Health (Bannockburn, IL)
- …accreditation, patient safety, quality monitoring, performance improvement, patient/ payer /referral source satisfaction, emergency preparedness, identification, and ... Management Programs, including patient safety, risk management, performance improvement, patient/ payer /referral source satisfaction, emergency preparedness and emergency response. Ensures… more
- Christus Health (Irving, TX)
- …providing appropriate follow up for patient needs.Based on CMS or other payer guidelines, patient assessment, and case conferences, makes recommendation to PCP re: ... patient's needs are addressed.Stays abreast of current CMS and other payer guidelines for HH services.Demonstrates expertise in navigating electronic medical record… more
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