- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and build contractual relationships with payers for direct ... a key member of the Waystar payer relations team, the Payer Relations Specialist will drive new value for Waystar's clients by unlocking new… 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 ... **Job Summary** The Part-Time Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital… more
- Johns Hopkins University (Baltimore, MD)
- …**Preferred Qualifications** + Epic experience. + Understanding of third party payer issues. Classified Title: Coding Specialist II Role/Level/Range: ATO ... We are seeking a _Coding Specialist II_ is responsible for understanding all aspects...aspects of coding, quality assurance, and compliance with Federal payer documentation guidelines. Works closely with departmental management and… more
- Pfizer (Harrisburg, PA)
- …enable Pull-through of access. + Collaboration partners include sales colleagues, government relations , Payer Channel Access (PCA), marketing, and other Pfizer ... improve their lives. **What You Will Achieve** The Specialty Healthcare Sales Specialist (SHSS) will target key Centers of Excellence (COE's) and select community… more
- Select Medical (West Orange, NJ)
- …Rehabilitation - West Orange** A Select Medical Hospital West Orange, NJ **Prior Authorization Specialist / Payor Relations Specialist ( RN , LPN )** ... **Job Responsibilities** Using discretion and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization… more
- University of Southern California (Alhambra, CA)
- …compliance regulations and guidelines, the HIM Coding Denials Management Specialist " analyze, investigate, mitigate, and resolve all coding-related 'claims denials' ... versus clinical-related denials, evaluating claims deemed inappropriately paid by the payer /external auditors, and determining the need for appeal. Performs all 1st… more
- Billings Clinic (Billings, MT)
- …needs for program expansion to Manager. * Works closely with Medical Staff, Payer Relations and Patient Financial Services to coordinate needed pre-certification ... to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Pre-Certification Specialist (Full-time) PRE-ACCESS (ROCKY MOUNTAIN PROFESSIONAL BUILDING) req10939 Shift:… more
- East Boston Neighborhood Health Center (Revere, MA)
- …Locations: 300 Ocean Avenue - Revere Position Summary: The Provider Enrollment Specialist is responsible for supporting the provider enrollment processes of the ... actions are performed at the time of provider departure. The Provider Enrollment Specialist verifies that data obtained from the provider and internal and external… more
- Trinity Health (Albany, NY)
- …& professional behavior & safe work practices. **Functional Role** Supports customer relations , physician relations , patient care & hospital business services by ... performing administrative & scheduling for multiple areas. ** Specialist I** Responsible for pre-registration, scheduling, electronically verifying insurance… more
- Tenet Healthcare (Detroit, MI)
- Rehab Care Coordination Specialist Full Time Days - 2506003435 Description : DMC Rehabilitation Institute of Michigan is one of the nation's largest hospitals ... skills to effectively resolve conflict. Promotes a positive customer relations environment. Coordinates the utilization review function for assigned patients.… more
- Banner Health (CO)
- …Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations , you'll find many options for contributing to our award-winning patient ... the contract supports the company/business unit goals. Works directly with vendors/ payer to negotiate and resolve contract issues, preparing contract documents for… more
- Charles B. Wang Community Health Center (Queens, NY)
- …in electronic health records + Establish linkage to external social services programs, specialist services and payer 's care management services + Participate in ... and ability to utilize the care plans + Communicate and establish effective working relations with care team + Advocate and work with patient and patients' family to… more
- Emory Healthcare/Emory University (Peachtree City, GA)
- …level of interaction with facilities and clients. Enhance and expand client relations with facilities and their staff. Evaluate and develop patients' plans of ... accurate documents of each patient's evaluation and progress letters to physicians and payer sources, case managers, etc. as indicated appropriately and in a timely… more
- PruittHealth (Norcross, GA)
- …and educate on the requirements of credentialing and re-credentialing. * Support the Payer Relations with reports and updates regarding participation status with ... all payers. * Maintain corporate standard time frame for completion of credentialing applications. * Perform special projects upon request * Excellent Communication, Customer Service and Time Management Skills * Handles any additional duties as assigned by… more
- Commonwealth Care Alliance (Boston, MA)
- …interpretation, and fee schedule issues. + Collaborate closely with Provider Relations , Contracting, Payment Integrity, Appeals & Grievances, and Configuration teams ... and recommend resolution pathways. + Interpret and apply MassHealth fee schedules, All- Payer Rate Setting regulations, and CMS payment methodologies (eg, DRG, APC,… 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
- 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
- Catholic Health Services (Melville, NY)
- …other patient access operational activities for the Catholic Health. The Authorization Specialist role is responsible to submit prior authorizations timely, and that ... required clinical criteria is complete and accurate according to payer requirements. The role will work closely with Utilization Management, Patient Accounts, and… more
- LifePoint Health (Las Cruces, NM)
- …This position collaborates with Credentialing, Care Management, technology platform, and payer representatives as appropriate. * High School Diploma or equivalent ... the assigned providers and practices. * Onboarding Education and Training. * Payer contract offerings. * Strategic network communication. * Performance reports and… more
- Sharp HealthCare (San Diego, CA)
- …and Hospital goals.Assists Team Leader with staff development in customer relations by increasing employee awareness when areas for improvement are observed. ... management.* Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other… more