- Novant Health (NC)
- …the direction of Member Processing & Credentialing Manager, the Facility Payor Credentialing Coordinator manages and coordinates facility credentialing of Novant ... manager in the application and credentialing process and acts as liaison with managed care organizations, self-insured businesses, insurance companies and Choice… more
- Novant Health (NC)
- …manager in the application and credentialing process and acts as liaison with managed care organizations, self-insured businesses, insurance companies and Choice ... Health members. . Responsible for volume management of initial applications that are received for ChoiceHealth members and assignment to a coordinator when deemed ready to process . Manages requests for recredentialing applications for providers, monitors the… more
- Select Medical (Akron, OH)
- …Specialty Hospital - Akron** **Select Specialty Hospital - Northeast OH** **One Select Senior Clinical Liaison ( RN , PT , OT , SLP , RT REQUIRED)** **This position ... as well as Inpatient Rehabilitation Hospitals** The One Select Senior Clinical Liaison helps the Director of Business Development lead the business development… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Patient Account Billing Liaison , CMG Business Office Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and ... changes to published Medicare and other payer billing guidelines/policies. The Billing Liaison must be able to answer policy guideline questions and provide… more
- Nuvance Health (Norwalk, CT)
- *Description* Summary: Responsible for all accountabilities of the Patient Access Liaison 1. Provides functional guidance to staff. Performs registration and ... payments. Responsibilities: 1. Performs all responsibilities of the Patient Access Liaison 1 position. 2. Communicates all information pertaining to the patient's… more
- Hawaii Pacific Health (Honolulu, HI)
- …skills and are gifted with numbers, you could be our next Physician Liaison Coder. This position works with coders, physicians and Revenue Management staff to ... coding experience. **Preferred Qualifications:** Associate's degree. Knowledge of physician payor contracts and services. Previous Training experience. EOE/AA/Disabled/Vets Hawai'i… more
- Sevita (San Francisco, CA)
- …children, adolescents, Military Service Members and Veterans. **Marketing Clinical Liaison ** **SUMMARY** Market programs regionally and performs clinical screens ... required, completes clinical screens to determine eligibility for programs and for payor and other stakeholder review of proposed supports and services. *Completes… more
- Nuvance Health (Poughkeepsie, NY)
- …for services rendered. 6. Performs insurance eligibility verification and executes payor requirements as needed. Includes initiating eligibility transactions via the ... internet, contacting the payor to obtain billing information and authorization and scripts for service when appropriate. 7. Provides estimates for services when… more
- Nuvance Health (Norwalk, CT)
- …rendered. Criteria B: Performs insurance eligibility verification and executes payor requirements as needed. Includes initiating eligibility transactions via the ... Internet, contacting the payor to obtain billing information and authorization and scripts for service when appropriate. Criteria C: Enters testing orders in the… more
- Ochsner Health (Jefferson, LA)
- …skills. + Knowledge of core therapy referrals and qualifying criteria by payor source, such as: TPN, Enteral Nutrition and Inotropic Agents for Medicare. ... + Ability to work with frequent interruptions and changes in priorities. + Must be able to work in stressful situations, while remaining objective and professional. **Job Duties** + Develops and maintains core therapy and service line admissions through… more
- Providence (Portland, OR)
- …coordination with various providers, the patient and/or caregiver, the physician and the payor . These services are provided in the states of Oregon and/or southwest ... Washington. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Home Services Oregon and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice… more
- Covenant Health Inc. (Knoxville, TN)
- …submission of primary, secondary, and tertiary claim billing via the clearinghouse, payor portals, and paper mailing. Reviews deficient claims (ie claim rejections) ... that are unable to be processed by the payor , makes corrections, and processes rebills as appropriate. +...balances via verbal and written communication. Act as a liaison between the patient, charge entry staff, and office… more
- Covenant Health Inc. (Knoxville, TN)
- …submission of primary, secondary, and tertiary claim billing via the clearinghouse, payor portals, and paper mailing. Reviews deficient claims (ie claim rejections) ... that are unable to be processed by the payor , makes corrections, and processes rebills as appropriate. +...balances via verbal and written communication. Act as a liaison between the patient, charge entry staff, and office… more
- Baptist Memorial (Memphis, TN)
- …general market conditions and the managed care market both provider and payor . Ensures application of appropriate business and legal protocol for contracting ... to comply with organization and departmental missions. Serves as liaison for contract communication with other organizational representatives. Manages contract… more
- ProMedica Health System (Toledo, OH)
- …privileges, payor /plan credentialing, certifications, and regulations. 2. Acts as a liaison between providers/office staff and hospitals or payor plans. 3. ... services, including diagnosis, modifier, and procedure codes, as well as additional payor requirements. 5. Accurately and timely input of billing information into… more
- AdventHealth (Maitland, FL)
- …in the financial structure, actuarial services, development and optimization of payor arrangements. o Accountable for reporting financials on contract performance ... regulatory and rate filings. o Serve as the executive liaison to our legal and compliance team within AH....financial concepts and levers across populations. o Advise on payor and vendor contract terms and negotiations. . Participation… more
- Albany Medical Center (Albany, NY)
- …the Albany Med Health System & its affiliates. Will serve as a liaison between internal clients and functional department including Albany Med Health System's ... the caseload for providers and assists with the NCQA payor and delegation audits and routine monitoring on an...annual basis. This position will assist with NCQA and Payor QA audits and the communication to the Payors… more
- Select Medical (Columbus, OH)
- …rehabilitation services in consultation with the field Clinical Liaisons,Senior Clinical Liaison , or Director of Business Development. Review and analyze medical ... are followed to minimize financial risk. + Maintain relationship profile by payor for payor case managers and medical directors. + Identifie by payor … more
- Mount Sinai Health System (New York, NY)
- …* Documents all clinical reviews in using designated site software program. * Liaison with Physician Advisor. + Case Management: * Assessment of the patient's ... a working knowledge of the UR requirements of each payor within the patient population * Provides the clinical...timely manner. * Coordinates the Discharge Appeal process. * Liaison with financial department for current insurance coverage. *… more
- Banner Health (Florence, AZ)
- …practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being ... basis for all scheduling requirements 2. Acts as a liaison between patients, providers and staff members for patients'...3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the… more
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