Job Search Results for healthcare payer

The Payer Enrollment Data Analyst manages and optimizes provider enrollment data under delegated payer agreements. This role ensures data accuracy, compliance with payer and NCQA standards, and... More supports integration, reporting, and audit readiness. It?s key to streamlining workflows, enabling timely reimbursement, and driving operational efficiency.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Insight Global is partnering with a Healthcare Start-Up based out of Nashville, TN who is looking for a Business Systems Analyst. This individual can sit remotely and requires to have strong... More experience within the Healthcare industry, specifically dealing with CMS and/or Payer data feeds. This individual must have experience with the data integration/ingestion portion, working on projects that deals with partnering with clients/vendors to define data feed exchange specifications, validate inbound feeds, provide feedback on data quality, and coordinate with cross-function teams to provide technical requirements to stage, transform, and integrate data feeds into Snowflake for analytics consumption. This position is a 6-month contract-to-hire that will convert and can pay $55-65/HR with a conversion salary of $120-135K.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Insight Global is seeking a Coding Education Manager for a large academic medical center in Virginia. The Enterprise PB Coding Manager for Coder and Provider Education is responsible for directing... More and managing the PB Coding education team supporting physicians, other healthcare providers, and medical coders on coding practices, documentation guidelines, and industry regulations. This position is responsible for the development of both coder and provider educational materials and standard procedures, as well as creating educational updates and programs to address any industry and regulatory changes that impact professional services documentation and coding. The manager also oversees both the coder and provider review process, ensuring documentation and coding is accurate and compliant with industry guidelines and regulations, ultimately leading to improved reimbursement and patient care.Manage the Coding team including but not limited to: hiring, training, managing & evaluating team performance and conducting professional development plans.Ensure that the productivity and actions of the Coding team meet and support the overall operational goals of the department and institution.Assist Director with development of annual budget.Design, develop and execute standard policies and procedures, and strategies targeted to improve the quality of documentation, data integrity, and overall quality of patient outcome reporting.Develop and execute Coding process improvement projects (department and institutional wide)Collaborate extensively with members of the health care team to provide data and solution development processes.Inform and educate coding staff or other departments (as needed) of regulatory (CMS/Medicaid) and 3rd party payors and implements policy/guidelines to ensure compliance with changes.Responsible for serving as the primary point of contact for interactions with internal and external customers to CBO, primary decision maker regarding collection activities with third party insurance and guarantors.Assures compliance with state law mandates on collections associated with the Medical Centers status as an agency of the Commonwealth.All inquiries responded to in an efficient, accurate, and timely manner. This includes driving improvement in customer satisfaction, employee development and retention, as well as, overall operational efficiencies are maximized.Identifying areas for improvement applicable to Revenue Cycle performance within all or one facility included in the CBO.Accountable for Key Performance Indicators (KPIs) for assigned area(s).Assists team members with working a client's account as needed, including but not limited to denials, rejections, claim files issues, and review codes.Identifies trends affecting the CBOs A/R and facilities specific metrics; collaborates with the operational team to ensure the overall health of the assigned facilities.Assists with team development, including on-going mentoring and trainingPursues continuing education of applicable software and hardware as necessaryKeeps current on payment trends and coding changes as well as payer requirement changes.Participates in departmental and other meetings as requestedAssists with creating procedures/process documentation.Communicates all A/R issues, including enhancement requests, defects, and inquiries, to internal stake holders.Build and maintain strategic relationships with external and internal customers.Develop reputation as an industry expert and trusted advisor on revenue cycle and management processes for given specialty areas of focus.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less