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The Physician Revenue Cycle Reimbursement Analyst (remote) role will perform various functions centered around data analytics and reporting, charge master & fee schedule management, and maintaining overall revenue integrity across multiple state markets.
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The Field Reimbursement Manager will be responsible for the management of defined accounts in Urology and Oncology area, specifically supporting our client's product. The Field Reimbursement Manager will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including acting as an extension of patient support program and in other collaboration with other partners.
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The Reimbursement Manager will also work on patient level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI), navigating access issues, and working with payer and NCCN guidelines for product utilization.
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Support patient access assistance from prescriber decision through to fulfillment, supporting the entire Reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms.
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Must have general payer policy knowledge including public & private payers, foundational knowledge of benefit verifications & prior authorization/pre-determination requirements (including appeals/exceptions), & knowledge of access & reimbursement processes within various sites of care.
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Provide in-person or virtual one-on-one support to address questions about coding, coverage, reimbursement, and patient support requirements. Responsibilities include ensuring understanding and communicating Reimbursement, access, and program support program as it relates to the product.
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ADARs are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage, multi-channel acquisition pathways, billing and coding (as needed), claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.
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The Clinical Reimbursement Manager completes education for new team members on timeliness, accuracy, MDS section completion definitions, CAA completion and the resident care plan. The Clinical Reimbursement Manager completes and codes the nursing sections of the RAI autonomously on behalf of the facility and makes independent clinical decisions regarding care plan development utilizing the data from the MDS, other information gathered from the clinical record, resident interviews, and physical assessments of the resident.
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The Field Reimbursement Manager (FRM) will support physicians and their reimbursement staff, in working with patient reimbursement for buy-n-bill models and specialty pharmacy distributed products.
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Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement; Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education.
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The Senior Manager - Immunology Access & Reimbursement, will be a field-based role focused on supporting appropriate patient access by educating healthcare providers and their staff on product coverage, support service offerings, Specialty Pharmacy logistics and the overall reimbursement process related to BMS products.
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Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail) The Associate Director, Access & Reimbursement, Radioligand Therapy (RLT) is a remote/field-based role that covers the following states but not limited to, Miami, FL, Boca Raton, FL & Puerto Rico. The Associate must reside within territory, or within a reasonable daily commuting distance of 60 miles from territory border.
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As Reimbursement Analyst, you will provide reimbursement maintenance and project support for topics such as hospitals, home health agencies, health clinics, Durable Medical Equipment, primary care, fee schedules, managed care, value care, graduate medical education, and supplemental payment programs.
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The Reimbursement Quality Audit & Documentation Specialist will work closely with the Reimbursement QA Supervisor to perform quality assurance activities with the focus on monitoring and improving reimbursement collection efforts.
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Keywords: MDS, pdpm, mds 3.0, registered nurse, rn, mds coordinator, regional director of clinical reimbursement, regional mds nurse, rn, registered nurse, RN, MDS, mds coordinator, rai, resident assessment coordinator.
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Title: reimbursement manager Company: Hdis
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