Manages comprehensive Precertification integrity system and works toward goals and objectives for departmental denial management. Has a sound understanding of the payor policies related to denials and appeals process for all Institutes deemed within Healthcare Access scope. Reviews and analyzes denial data for all Institutes within the scope of HCA to determine denial tre

Manages comprehensive Precertification integrity system and works toward goals and objectives for departmental denial management. Has a sound understanding of the payor policies related to denials and appeals process for all Institutes deemed within Healthcare Access scope. Reviews and analyzes denial data for all Institutes within the scope of HCA to determine denial tre

This opportunity is full time at 40 hours per week, offers full benefits and a convenient day shift schedule. Wellington Regional Medical Center is located in Wellington, Florida. It is a 235 bed, acute care hospital, owned by a subsidiary of Universal Health Services, Inc., a highly respected healthcare management organization. Wellington Regional is proud to have provid

This is a per diem position. Wellington Regional Medical Center is located in Wellington, Florida. It is a 235 bed, acute care hospital, owned by a subsidiary of Universal Health Services, Inc., a highly respected healthcare management organization. Wellington Regional is proud to have provided high quality healthcare services to the residents of Palm Beach County since 1

Insures patient accounts are handled according to hospital policy and that contacts with the public are conducted in a concerned and efficient manner Enter detailed notes explaining account activity in the Patient Accounts system Determine and assist but not limited to qualifying patients for Indigent, Bankruptcy, Deceased, Financial Assistance, Medicaid eligibility, Pres

Eligible for a $2,500 Sign on Bonus Eligible for Full Time Benefits Shift Full Time The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other internal and external individuals. Is a subject matter expert in the resolu

At Boston Children's Hospital, the quality of our care and our inclusive hospital working environment lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices

The Manager Physician Practice II has an increased scope and span of control over Practice Operations. Responsible for the daily operations of the physician practice to include the provision of quality services to patients, the promotion of teamwork among the staff, maintenance of the building and equipment, compliance with all applicable policies and procedures and opera

Purpose This is a full time position to serve as a member of the Office of Risk and Compliance at Dell Medical School generally focusing on the University of Texas at Austin's clinical practice, UT Health Austin. This position is responsible for policy management at UT Health Austin. The Policy Administrator reports to the Office of Risk and Compliance. The position works

1. Performs review of new Workers' Compensation claims in order to ensure compensability, proper documentation of injury, completeness of information and determine current medical status. 2. Regularly involved in negotiations with claimants, physicians, attorneys and the Commissioner to determine appropriate course of action necessary for efficient claims management or se

The Director of Health Plans/Network Contracting is responsible for collaborating across organization in the creation and execution of the network strategy for all US Family Health Plan and CHRISTUS Health Plan product lines. This position provides leadership and guidance to cross functional areas and works closely with health plan and population health staff to implement

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life threatening illnesses. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and trea

Reviews clinical authorization denials and determines appropriate actions per payor to overturn the denial. Functions as a hospital liaison with external third party payors to review authorization denials. Job Duties Monitors and completes claims on team appeals, reconsiderations, and claim investigations. Works with the precertification department and other physician off

The Accounts Receivables (A/R) Representative assists in review and resolution of hospital claims under general supervision of the Patient Financial Services Supervisor. Posting, processing and balancing activities related to third party remittances on both hospital and physician based claims and all forms of payments received from patients. The Payment Applications Repre

We have an exciting opportunity to join our team as a Data Entry Operator (Evenings), Bacteriology Section of Labs. In this role, the successful candidate performs clerical and support activities necessary to assist in laboratory operations and all areas of specimen receipt and registration. Serves as a communications resource and facilitates transfer of information both