Understanding U.S. Healthcare Payer Systems for Recruiters

The following Understanding U.S. Healthcare Payer Systems for Recruiters course is designed to educate healthcare recruiters on healthcare payer structures, coverage programs, and payer-related terminology used when interpreting healthcare requisitions.

What you will learn:

• Roles of patients, providers, facilities, payers, health plans, and employers

• Private, employer-sponsored, Marketplace, Medicare, Medicaid, and CHIP coverage

• How payer information may appear within healthcare requisitions

• Provider networks, managed care, prior authorization, and referrals

• How to distinguish the payer, employer, facility, population served, and work function

• Recruiter responsibilities and limitations when discussing payer-related positions

Once completed, you will receive a certificate of completion. Course length:45 mins.

The information contained in these trainings was derived from publications of the U.S. Centers for Medicare & Medicaid Services (CMS), including HealthCare.gov, Medicare.gov, and Medicaid.gov (Government Sourced Material). None of the planners, authors or instructors for this activity have any relevant financial relationships to disclose. The Government Sourced Material used by AMC is available at no charge on their associated websites. The use of the Government Sourced Material by AMC does not imply endorsement or recommendation by CMS or by the United States Government, of AMC, its enterprise, its facility, its services or its products. © 2026 American Medical Compliance, no copyright claimed in Government Sourced Material. If you are not completely satisfied with this course within 30 days you will receive a full refund.