Account Service Manager - Payor Contracting Job at Elevance Health

New

Patient Financial Specialist - Patient Financial Services

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred.

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution
Meets or exceeds customer expectations and requirements
Compliant with all CHRISTUS Health, payer, and government regulations

Fulltime

New

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution

Fulltime

Patient Financial Specialist - Patient Financial Services

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
Post HS education preferred
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred
None required

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution

Fulltime

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution
Meets or exceeds customer expectations and requirements, and gains customer trust and respect

Fulltime

Regional Account Executive

In this business development role you will be responsible for seeking out new bu...

Location

United States of America , Remote, Michigan

Salary:

70000.00 - 75000.00 USD / Year

WellNow Urgent Care

Expiration Date

Until further notice

Requirements

3+ years of demonstrated sales and business development experience preferably in an Occupational or Employee health related field
Demonstrated general knowledge of care delivery, billing, case management, and state regulation standards within the Occupational Healthcare Industry
Ability to perform complex negotiations – which includes dealing with senior executives and multiple decision makers in large diverse organizations
Ability to articulate effectively and in a concise manner
Ability to work both independently and in a team environment
Strong interpersonal and communication skills and the ability to work effectively with a wide range of people
Ability to create, compose, and edit written materials
Skill in organizing and establishing priorities
Must be detail-oriented and well organized
Basic financial analysis and visit trend review skills

Job Responsibility

Develop strategic marketing and sales planning with top executives
set objectives and methods to reach them
Close new business by developing and negotiating contracts and integrating contract requirements with business operations
Work with other department heads and staff to coordinate account setup and implement service delivery
Develop proposals in response to requests for proposals (RFPs)
Deliver sales presentations and participate in meetings with clients and external vendors or advisors
Maintain accurate records of all sales and prospecting activities, including sales calls, appointments, closed sales, and follow-up activity within assigned territory using a CRM (Customer Relationship Management) tool
Identify sales targets and leads, develop a sales funnel with expected outcomes of closing the leads and secure the targeted business opportunities
Develop and execute individual account sales plans to secure new customer prospects daily
Meet minimum monthly revenue goals established by Senior Management

What we offer

paid time off
health
dental
vision
401(k) savings plan with match

Fulltime

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution
Meets or exceeds customer expectations and requirements, and gains customer trust and respect

Fulltime

Director Provider Account Management

JOB SUMMARY: Responsible for leading growth, maintenance and implementation of c...

Location

United States

Salary:

86000.00 - 141800.00 USD / Year

One Call

Expiration Date

Until further notice

Requirements

Bachelor’s degree (B.A. or B.S.) and/or a Master’s degree (M.A., S. or M.B.A.) in Business or Accounting
Minimum of five (5) years of experience in health care services
Three (5) years of management experience
Five (5) years of experience in provider relations and/or Account/vendor Management, or a related area
A combination of equivalent education or experience
Minimum of 10 years of successful provider contracting and/or Account Management experience including: Excellent provider relations experience and thorough knowledge of managed care practices and provider contracting, either in a provider or payor capacity
Extensive experience and thorough knowledge of provider reimbursement methodologies, financial modeling, business analytics and reporting, provider coding and billing procedures, and related concepts and terminology
Thorough knowledge of insurance terminology, concepts, and benefits issues, including actuarial and underwriting relationships to provider rates and services, member benefits, and cost sharing attributes
Excellent verbal communication skills, including listening effectively, persuasive negotiation skills, and communicating strategic and technical issues to individuals and in presentations to groups
Ability to comprehend and interpret managed care contract terminology and thorough knowledge of quantitative analysis related to provider reimbursement

Job Responsibility

Direct team activities while working with the manager on items, including Key Account updates, cross functional projects, savings initiatives, revenue growth, and new product opportunities
Guide the manager in working with team to maintain critically important providers, integrated provider systems, and provider networks that support business needs and align with corporate priorities while working to identify gaps in coverage with a plan to address
Support the manager leading the team in building and maintaining productive relationships with key accounts while enforcing One Calls value propositions in the marketplace
Lead Managers in reporting and forecasting key operational functions and data analyses necessary to support provider contracts/current key accounts so the One Call’s work units can create complete, timely, and accurate workflows and support for provider networks and contractual provisions working with team to ensure they are as effective as possible
Meet with managers to discuss/report up on any potential regulatory changes, analyze contractual language periodically, as well as the parties' obligations and overall relationships to ensure agile response to market conditions, necessary regulatory compliance, and adequate network access
Support manager to share and maintain thorough knowledge of existing and emerging contract arrangements, regulations, and pricing trends
renegotiate contracts where improvements are needed
Lead and meet with managers on regular cadence to monitor contract performance of providers
analyze relevant reports
identify reporting, administration, reconciliation, and systems opportunities for improvement

Fulltime

Managed Care Senior Manager

Corporate level manager responsible for deploying and contributing to strategic ...

Location

United States , Fort Lauderdale

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors
Five (5) years contracting experience with three (3) years contracting for hospital, professional services, ancillary facilities or specialty networks

Job Responsibility

Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation
Execute contracting strategies for all service lines in Memorial Hospitals, MHS employed physicians, transplant programs, and ancillary services of the fully integrated healthcare delivery system and its joint owned or joint ventured entities for fee for service and value based arrangements
Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with national and regional payors
Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions
Enhance, estimate and preserve net revenues
Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution
Execute strategies and guides operations to protect and build market share
Interface with managed care plans on claim reconciliations, trended issues and operational projects
Determine root cause and seek resolution
Evaluate payor assessments of overpayments and effectively dispute or resolve for settlement

Fulltime

Select Country

Account Service Manager - Payor Contracting

Job Description

Job Responsibility

Requirements

Nice to have

What we offer

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