, value-based care, or chronic disease management policy. Familiarity with commercial payer dynamics to help bridge...
with large provider organizations and specialty physician groups. · Leverage deep knowledge of payer–provider dynamics... and third-party payer contract management experience. · Experience with PHO, physician, and hospital negotiators...
to assigned payer accounts for a book of business with annual revenue up to and exceeding $100MM. Manages self as well as team... to mutual accounts between payer and division Participate with internal teams to assist in the development of customer...
for business development and sales/physician relations team. · Maintains keen understanding of the payer, hospital and physician...
registrations, and payer enrollment coordination. 3. Manage provider relations by serving as a key point of contact for new...
effective communication skills in patient/physician relations, and maintain current understanding of governmental and payer... of insurance plans utilizing electronic eligibility tools, phone calls payer, accesses web portals and initiates appropriate action...
) code is submitted in relation to the rendered procedure Type of Service (TOS) at the charge entry level based on the payer... specific requirements. Ensure the charges for bilateral services are processed in accordance with payer specific guidelines...
, payer imbursement policies, regulatory and administrative rules). Understands reimbursement/funding resources... an accommodation in relation to the online application process, please contact us by completing this form ....
, and benefit and eligibility information Meets payor pre-authorization requirements to secure full insurance or government payer... active payer sources for patients, or refers to financial counseling for third-party linkage or financial assistance...
care - LTPAC, Ambulatory, Acute and payer experience A natural ability to thrive in a fast-paced environment... this information to evaluate your candidacy for the posted position. We also store this information, and may use it in relation...
computer skills, basic accounting, detailed clerical skills and good customer relation skills are required. Candidate... must manage accounts according to third party payer rules and regulations. Candidate must posses an understanding of medical...
requirements to secure full insurance or government payer reimbursement Documents all required scheduling, financial clearance... is recorded For uninsured patients, identifies and verifies active payer sources for patients, or refers to financial counseling...
paperwork, demographics, physician orders, patient health history, payer information criteria is met prior to admission.... · Requires excellent communication skills (including verbal, written and human relation); exercise professional telephone...
management in relation to patient registration and scheduling; payment processing and charge reconciliation; message and work... and experience accessing/verifying insurance coverage. Experience using Real Time Eligibility (RTE) and Payer/Insurance Portals...
to initiate and mediate Physician to Physician reviews. Understands and retains knowledge of payer requirements in relation... of full verification, and payer information / requirements Essential Tasks and Responsibilities Responsible for ensuring...
direction to the Case Management staff in relation to denials/appeals which includes training and monitoring of staff competency.... Provides information and Interpretation of third party payer guidelines. Confers with the attending physician to determine...
of receivables on facility contracts coming up for renewal Pre-verification on the payer types of governmental agency or private... Intermediate knowledge of Microsoft Word and Excel Problem-solving abilities Excellent communication and customer relation skills...
, patient/family satisfaction, utilization, and cost. Complies with related Federal, State, Payer and regulatory requirements... and with consideration for safety, possibility for readmission, length of stay, cost effectiveness and payer requirements. Consults...
, patient/family satisfaction, utilization, and cost. Complies with related Federal, State, Payer and regulatory requirements... and with consideration for safety, possibility for readmission, length of stay, cost effectiveness and payer requirements. Consults...
, and validation of reimbursement from third party plans in relation to the hospitals negotiated fees and adherence to contract terms... for the preparing of reports regarding contractual variances along with payer issues to leadership and work with the Managed...