adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract... for summarizing key contract data elements which are populated into the Managed Care database including addition of new payers, auto...
. Supports the Managed Care Contract Administration, AH Central Denials team, and AH Regional PFS departments as applicable... for government and non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference...
and accurately with Managed Care contracted payers. Responsible for evaluating professional fee contractual adjustments for accuracy... identification for the Physician Enterprise (PE) and works closely with practice office operations staff, Managed Care (MC...
and new contract requirements. Supports the overall mission of AdventHealth and the role of the Managed Care department... to complete credentialing and re-credentialing of all ancillary groups for which we contract. Maintains a working knowledge of the...
, compliance, and basic billing rules for Government and Managed Care payers. Uses discretion when discussing personnel/patient... payers to ensure proper billing takes place on all assigned patient accounts. Depending on payer contract may...