- ProMedica Health System (Toledo, OH)
- The Payor Specialist is responsible for ...of all inpatient and observation admissions systemwide with per payor contract via phone, fax, and payer ... admission using various WQs assigned in Epic. Submits clinical information per payor contract via payer portals, fax or Secure Outlook email to obtain… more
- HonorHealth (Phoenix, AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Payor Enrollment Specialist is responsible for providing enrollment and ... to insurance and health plans to support the processing of payor applications and reapplications. Provides enrollment support to the centralized appointment… more
- Sevita (Boston, MA)
- …and specialized services for infants, children, adolescents, Military Service Members and Veterans. ** Contracts and Payor Senior Specialist ** Do you have an ... + Work in partnership with senior leadership, Program Directors, and Director of Contracts and Payor Engagement to ensure consistency and secure public and… more
- Select Medical (West Orange, NJ)
- **Overview** **Kessler Institute for Rehabilitation** West Orange, NJ **Prior Authorization Specialist / Payor Relations Specialist - This is an** **onsite** ... **Responsibilities** **Job Responsibilities** Using discretion and independent judgment, the Payor Relations Specialist manages the pre-certification and prior… more
- Select Medical (Frisco, TX)
- …**Responsibilities** **Job Responsibilities** Using discretion and independent judgment, the Payor Relations Specialist manages the pre-certification and prior ... with Select Medical & Baylor Scott & White Health **Prior Authorization Specialist -** **onsite only** **This position must work** **onsite** **at** **Baylor Scott… more
- Sonora Quest (Phoenix, AZ)
- …professional standards._ **CORE FUNCTIONS** 1. Conducts initial review of proposed contract language. Reviews and revises proposed contracts , ensuring compliance ... Shift:** Day **Job Category:** Legal **POSITION SUMMARY** This position administers contracts for the organization. This position participates in the development and… more
- ProMedica Health System (Toledo, OH)
- …making sure each are resolved. This includes items like billing issues, contract loading issues, credentialing issues and inpatient and post acute prior ... data to identify industry changes and policies made to managed care contracts and reimbursement 4. Negotiate and manage administration of all value-based agreements… more
- Houston Methodist (Katy, TX)
- …of the requirements of the Government and Non-Government payment policies and payor contracts . Additionally, this position identifies accounts with payment ... is a plus** At Houston Methodist, the Payment Variance Specialist position is responsible for ensuring that all claims...to the appropriate leadership for the purpose of enforcing Payor Contract Compliance. This position works both… more
- Elevance Health (Plano, TX)
- …not limited to: + Gathers, records, and maintains credentialing information for new payor contract applications and renewals. + Primary duties may include, but ... infusion centers, and the home setting._ **Title:** Managed Care Credentialing Specialist (Risk Management Analyst) **Location:** This position will work a hybrid… more
- Rush University Medical Center (Chicago, IL)
- …ad-hoc reports as needed * Maintains knowledge of current, new, and terminated payor contracts while communicating such updates to peers and management * ... working knowledge of physician and hospital appeals, underpayment/overpayment disputes, and payor contract management * Knowledge of EPIC applications preferred… more
- R1 RCM (Chicago, IL)
- …and/or contractual appeal letters when applicable + Interpreting and calculating payor contract reimbursement methodology + Preparing Excel analysis, including ... AI, intelligent automation, and workflow orchestration. As our Revenue Integrity Specialist (RIS), you will be responsible for identifying underpaid payment… more
- Integrative Emergency Services (Dallas, TX)
- Integrative Emergency Services, LLC ("IES") is looking for a Provider Enrollment Specialist to support the division in facilitating the enrollment (submitting of ... with Enrollment Coordinators. + Prepares applications for new providers for multiple contracts sites, payors, and states requiring an acute attention to detail,… more
- Omaha Children's Hospital (Omaha, NE)
- …with disabilities. **A Brief Overview** Collects outstanding insurance and government payor accounts and unpaid balances via telephone, email, and mail. Verifies ... the accuracy of all insurance and government payor payments, rebills underpayments, appeals denials and turns them...+ Ability to review, interpret and understand managed care contracts and EOB's with third-party payers to ensure appropriate… more
- Cedars-Sinai (Los Angeles, CA)
- …revenue cycle. Incumbents have expert knowledge and understanding of regulatory requirements, payor contracts and CSHS policies governing billing and collections ... of speed and accuracy. + Demonstrates expert knowledge of payor practices, policies and procedures as well as the...**Req ID** : HRC1388706 **Working Title** : Revenue Cycle Specialist IV - Anesthesia **Department** : CSRC PB -… more
- Cedars-Sinai (Los Angeles, CA)
- …revenue cycle. Incumbents have expert knowledge and understanding of regulatory requirements, payor contracts and CSHS policies governing billing and collections ... of speed and accuracy. + Demonstrates expert knowledge of payor practices, policies and procedures as well as the...**Req ID** : 1466 **Working Title** : Revenue Cycle Specialist IV **Department** : CSRC PB - Group **Business… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …the Reimbursement Specialist I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all payments ... SUMMARY: Under the direction of PFS Leadership, the Reimbursement Specialist I is responsible for billing and collections of...Specialist I is required to identify and report payor issues to their leadership. It is a requirement… more
- Cedars-Sinai (Los Angeles, CA)
- …Service, analytic and problem-solving skills, and can understand, interpret, and explain payor contracts and CSMC Billing and Collections Policy and Practices ... dialog with payors, patients and departments. + Understanding of payor contracts . + Successful completion of PRMPT...**Req ID** : HRC1346975 **Working Title** : Revenue Cycle Specialist III **Department** : CSRC PB - Group **Business… more
- Omaha Children's Hospital (Omaha, NE)
- …including veterans and people with disabilities. **A Brief Overview** The billing specialist ensures, through various activities, that claims are clean and should be ... needed, and collecting necessary details to ensure claims are complete. The billing specialist 's activities result in claims that can be submitted to payers without… more
- Select Medical (Camp Hill, PA)
- …refund requests. + Notify database operations of changes or additions to specific payor , plan, contract , address, or other pertinent information as necessary. + ... **Overview** **Claims Resolution Specialist ** **Starting at $17.50 per hour** **ON-SITE** **(Hybrid...staff and department management on any accounts receivable issues/problematic payor trends. + Identify and resolve issues impacting the… more
- Spectrum Billing Solutions (Skokie, IL)
- …in the most efficient and streamlined manner. We are seeking to add a Credentialing Specialist to our growing team. If you are looking for a rewarding position where ... 100% fully remote. Your Responsibilities: + Complete provider credentialing and contract applications with third-party carriers and government health plans. + Review… more