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JOB SUMMARY:This position is responsible for managing Revenue Integrity Analyst and Denials Manager positions. Supervise and coordinate the activities of the Revenue Integrity employees – including charge creation and capture, audits, denials, etc.
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May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations.
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Consults with PHP medical directors and refers for medical director decisions on cases not meeting LTSS criteria, NF LOC denials and care plans that result in a reduction in service or benefit denial.
$44.49 an hourFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Closed door pharmacy experience is a plus. PTCB/CPHT Certification Required. At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. Performs drug calculations including basic mathematical calculations (e.g., converting milligrams.
$21 an hourExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Understanding of Revenue Cycle including admission, billing, payments and denials. Patient Access Staff are responsible for the pre-registration of patient accounts prior to patient visits. This position is an onsite role, candidates must be able to work on-site at Lovelace Medical Center in Albuquerque, NM.
Full-timeExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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Responsible for ongoing project work as related to day-to-day operations, as well as special projects to support leadership in analyzing, interpreting and assessing data related to effectively manage the accounts receivable and denials for the AR and Denials Division.
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Triage, interpret and input orders into computerized medication order system while meeting accuracy and productivity standards of the pharmacy. Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Business Office (admissions, discharges, insurance/payor verification, financial counseling, charge entry, billing, collections, denials) Our expert, customized treatment strategies offer relief from the debilitating symptoms of mental health conditions including depression, anxiety, borderline personality disorder, PTSD, ADHD, bipolar disorder, psychosis, and schizophrenia.
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DENIALS - Follow up on claims denials; contact appropriate party to research, coordinate and justify needed information; make appropriate corrections, obtain approvals and resubmit claims denials for payments; appeal denials through the payer required appeals process.
$16.49 - $24.08 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Performs complex billing activities such as processing aging reports, complicated or sensitive customer service issues, private insurance, Medicare and/or Medicaid pending claims and denials. Post-secondary education or equivalent training in a health care or business related field is required; Associate's degree preferred.
Full-timeExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Review open accounts to determine and take appropriate actions through understanding charges, billed claims, payments, denials, adjustments, and refunds. Review open accounts to determine and take appropriate actions through understanding charges, billed claims, payments, denials, adjustments, and refunds.
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Communication of authorization approvals and denials to management team. Experience in case management or disease management. Direct line of communication to external insurance Case Managers. Attains prior authorization for Part B therapy services as directed.
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