- Monster (Findlay, OH)
- … specialist will assist in identifying denials trends, research payer policies, understand coding guidelines, and provide assistance in finding resolution ... OF THIS POSITION The purpose of the Denials Management Specialist is to review the initial denial notifications for...solution and offers suggestions for improvements. Duty 5: Examines payer remittance advice and determines the cause of loss… more
- 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
- Medtronic (IL)
- …advanced degree) in the healthcare industry sector with significant exposure to market access, payer relations , and reimbursement roles. + At least 3 years of ... ever-changing environment. **Position Summary** Medtronic is seeking a US Payer Advocacy and Market Access Principal Specialist ,...US Payer Advocacy and Market Access Principal Specialist , a role responsible for driving patient and market… more
- Johns Hopkins University (Baltimore, MD)
- We are seeking a **_Coding Specialist II_** who will be responsible for all aspects of coding, quality assurance, compliance with Federal payer documentation ... to ensure a smoothly functioning billing operation and good patient relations . This includes coordination of the patients' financial billing responsibilities for… 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 Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to… more
- Johns Hopkins University (Baltimore, MD)
- We are seeking a **_Coding Specialist II_** is responsible for understanding all aspects of coding, quality assurance, and compliance with Federal payer ... for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. + Works closely with Office of Compliance for Professional… more
- Johns Hopkins University (Middle River, MD)
- …registration based on an understanding of the outpatient registration process. The Specialist will use an understanding of claims submission requirements for payors ... resolve standard issues or escalate to a more senior specialist . **Specific Duties & Responsibilities** + Uses A/R follow-up...special billing procedures that may be defined by a payer or contract. + Review and update patient registration… more
- Johns Hopkins University (Middle River, MD)
- …registration based on an understanding of the outpatient registration process. The Specialist will use an understanding of claims submission requirements for payors ... resolve standard issues or escalate to a more senior specialist . **Specific Duties & Responsibilities** + Uses A/R follow-up...special billing procedures that may be defined by a payer or contract. + Review and update patient registration… 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
- 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) req10481 Shift:… more
- Methodist Health System (Dallas, TX)
- …Description :** We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing to join our team at our Central Business ... and resolve no response claims, denied claims, and correspondence. As an AR II Specialist , you will play a crucial role in optimizing revenue flow by effectively… 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
- 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 ... Full-Time Care Management Specialist Reports to: Manager, Care Management Services Queens/Manhattan,...the care plans + Communicate and establish effective working relations with care team + Advocate and work with… more
- Intermountain Health (Wheat Ridge, CO)
- …for effective pre-registration and pre-visit preparation as needed. Also collaborates with Payer Relations to provide the required documentation relating to any ... **Job Description:** The Contact Center Referral Specialist processes insurance pre-authorization for primary and specialty service office visits and testing.… more
- Methodist Health System (Dallas, TX)
- …States of America) **Job Description :** Your Job: The Cash Application Specialist will provide excellent customer service, accurately posting payments and handling ... Job Responsibilities: * Accurately post and allocate all payments per vendor or payer details to patient accounts. * Ensures accuracy of cash application by… more
- Staffing Solutions Organization (OH)
- …-** **Enrollment/Call Queue Support** + Respond to inbound calls to the provider relations line. Calls can include a range of inquiries including application status ... year of the experience must have included provider monitoring, Medicaid or third-party payer provider billing, or provider training. One year of the experience must… 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
- 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
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating appropriate length of… 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
