- Caris Life Sciences (Irving, TX)
- …**Position Summary** Caris Life Sciences is seeking a full-time **Billing Operations Manager ** to lead and manage the **Eligibility** function within our Billing ... eligibility processes are compliant, efficient, and patient-focused. The Eligibility Manager provides leadership, training, and performance management to staff,… more
- Stony Brook University (Stony Brook, NY)
- …timelines. + Work closely with nurse case manager /social worker team regarding payer delays, authorization and denial notification. + Serve as a liaison ... Temporary Discharge Manager **Position Summary** At Stony Brook Medicine, a...closely with Nurse Case Managers and Social Workers regarding payer delays, authorization and denial notification. Individual… more
- Stony Brook University (Stony Brook, NY)
- …with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer from other hospitals. + Consistent documentation ... RN Case Manager **Position Summary** At Stony Brook Medicine, a...of care from initial assess point. Follows cases for authorization for in patient stay. + Staff review short… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Manager of Payer Connectivity for Prior Authorization plays a pivotal role in optimizing how healthcare providers and payers ... internal stakeholders at all levels. + Deep understanding of healthcare administration, payer operations, and prior authorization processes. + Familiarity… more
- Carle Health (Urbana, IL)
- Overview Manages the daily activities of Patient Access Medical Insurance and Prior Authorization departments to ensure high quality customer service and improve ... policies consistently + Manages daily activities of the Medical Insurance and Prior Authorization departments + Ensure quality and quantity of work… more
- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the… more
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** The Prior Authorization Specialist I is responsible for obtaining and resolving ... referral, precertification, and/or prior authorization to support insurance specific plan...background and clinical information that is required for the payer to issue a referral or an authorization… more
- J&J Family of Companies (Milwaukee, WI)
- …billing. + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... + Immunology disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access… more
- J&J Family of Companies (Trenton, NJ)
- …solutions (eg co-pay assistance) + Reimbursement or relevant managed care experience ( prior authorization , formulary exception and appeals processes) + Ability ... Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will...disease experience + Advanced degree and/or relevant certifications in prior authorization + Strong market access acumen… more
- J&J Family of Companies (Sacramento, CA)
- …billing + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position in the...state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding +… more
- Regeneron Pharmaceuticals (Charleston, WV)
- … Payer Formularies and restrictive Utilization Management Criteria including: Prior Authorization Processes, Step Edits, Appeals, detailed Clinical ... **Field Reimbursement Manager , Immunology - Pulmonology and Gastroenterology-Charleston, WV** The...and divisional reimbursement strategy for Regeneron products within various payer segments. The RBM position requires the ability to… more
- Guthrie (Sayre, PA)
- Summary The Denial, Appeal, and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes within the ... of claim denials, effective appeal strategies, and proactive audit response. The manager leads a team of specialists, coordinates with internal departments, and… more
- Abbott (Austin, TX)
- …Assist sites with Medicare, Medicare Advantage, Medicaid and Private Payor prior authorization , pre-determination, and appeal requests for subjects participating ... than 500,000 people with diabetes from routine fingersticks. The **Associate Manager of Clinical Trial Reimbursement** is responsible for implementing and managing… more
- Carle Health (Normal, IL)
- Overview The Manager , Patient Access manages the daily activities of Carle Bromenn Medical Center outpatient registration, Carle Bromenn Outpatient Center, Guest ... denials and improve overall AR performance. Understands regulatory and third-party payer guidelines for Emergency room visits, Inpatient and Outpatient admissions to… more
- Whidbey General Hospital (Coupeville, WA)
- …right care at the right time-we'd love to meet you! The RN - Care Manager is a health care professional with experience and background to assure compliance with CMS ... of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an assessment to identify the patient's clinical needs to be… more
- Adecco US, Inc. (Richmond, VA)
- …assigned territory focused on supporting specific drug (including Benefit Investigation, Prior Authorization , Claims Assistance, and Appeals) and educating the ... clients with their search to fill a Field Reimbursement Manager role in Richmond or Roanoke, VA area. **This...office on Payer landscape and services available through both remote interaction… more
- Cardinal Health (Bismarck, ND)
- …intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up ... better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class...appeals process if needed. + Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes.… more
- Billings Clinic (Billings, MT)
- …across Billings Clinic. This position ensures that pre-registration, insurance verification, prior authorization , and patient financial counseling processes are ... analyzing and reporting key performance indicators (KPIs), including registration accuracy, prior authorization turnaround, and patient satisfaction Compliance /… more
- Sanofi Group (Los Angeles, CA)
- …field subject matter expert relating to patient support, access, reimbursement, prior authorization , appeal, financial assistance, and other business-related ... HIPAA compliant contact + Support field in education of office personnel on prior authorization and appeals processes, reimbursement support, free drug programs,… more
- Cardinal Health (Topeka, KS)
- …the patient journey, including referral intake, benefit investigation (pharmacy and medical), prior authorization , and therapy delivery. . Actively advocate for ... better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class...costs, and appeals processes. . Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes.… more
