Files appeals on denied claims and/or forwards to the Nurse Auditor for review if applicable Maintain better than an 80% clean claim average. Attach but not limited to the medical records, implant invoices, and itemized bill to the claim when applicable Process incoming mail correspondence from the payers within 5 business days Work assigned billing reports within 2 busin

This classification learns to perform eligibility determination work of average difficulty. An employee in this class is customer facing and learns to interview customers and determine eligibility for SNAP and TANF programs. This classification performs responsibilities at the learning level under direct supervision. This class differs from the Eligibility Counselor 2 in

The Patient Financial Advocate I is responsible for serving as the point of contact for all functions and workflows within Revenue Cycle Pre Arrival financial management. Through conducting of a variety of tasks such as creation of price estimates, counseling patients regarding insurance coverage and benefits, arranging payment plans, assessing referrals for care, handlin

This classification learns to perform eligibility determination work of average difficulty. An employee in this class is customer facing and learns to interview customers and determine eligibility for SNAP and TANF programs. This classification performs responsibilities at the learning level under direct supervision. This class differs from the Eligibility Counselor 2 in

The Sr. Analyst must be able to work successfully with cross functional teams and have the maturity to interact directly with both peers and executives across departments. The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive. Write SQL queries against data warehouses containing clinical oper

Position Title Pre Registration/Insurance Verification Representative Full Time, Days Department Admitting Job Description General Description Responsible for timely and accurate pre registration and insurance verification. Accurately interprets managed care contracts. Essential Responsibilities Perform pre registration and insurance verification within 24 hours of receip

Help process provider applications and re applications including initial mailing, review and loading into the database tracking system Conduct audits and provide feedback to reduce errors and improve processes and performance Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others Solve complex problems on own; proactively ide

Under Terros' Health's policies and professional requirements, the Clinical Intake Specialist participates as a member of an interdisciplinary clinical team working with individuals diagnosed with General Mental Health and Substance Use diagnoses. Works in conjunction with the intake clinician to complete the initial intake requirements, assigns patients to appropriate tr

Medicare Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America Rochester Office, 220 Alexander Street, Rochester, New York, United States of America Req #1073 Friday, March 4, 2022 Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full

Reviews, processes, and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. Provides prompt feedback to physicians and management regarding pathway documentat

PRIOR AUTHORIZATION SPECIALIST Job Locations US CO ENGLEWOOD ID 2024 142388 Line of Business Amerita Position Type Full Time Pay Min USD $18.50/Hr. Pay Max USD $28.00/Hr. Our Company Amerita Overview Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. A

Job Description Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other h

The Department of Internal Medicine in the University of Iowa Carver College of Medicine is seeking an outstanding physician scientist Health Services Researcher for an Assistant Professor tenure track faculty position. The successful candidate must have an MD or equivalent medical degree and biomedical informatics fellowship training. Completion of an ACGME accredited Re

Requires daily contact with customers, attorneys, bank officers, and insurance agents by phone and/or letters Order flood determinations for new commercial loans in process Reviews all commercial and mortgage new loans for proper hazard/flood insurance coverage/documentation Tracks flood insurance policies for lapses in coverage Prepares and sends required regulatory lett

Provider Analyst II Provides analytical support during contract negotiation process. Assists contracting in building tools that model rate. Organizes and performs analytical review of opportunities with provider networks. Performs claims repricing, discount analyses, etc. to support group sales efforts and RFPs. Provides understanding of financial impact based on history.