- WTW (Arlington, VA)
- **Description** Do you want to be at the forefront of insurance industry innovation and leadership? Do you want to partner with insurers across North America to help ... is looking for a pricing expert with Small Business insurance pricing experience in the US market to join...our team of pricing, portfolio management, underwriting, finance and claims experts to deliver consulting and technology solutions to… more
- Elevance Health (Richmond, VA)
- …Alternate locations may be considered. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...CEMC and CEDC encouraged. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (Richmond, VA)
- …design, program evaluation and effectiveness methodologies, and statistical sampling for health plan functions. Will leverage large, complex, and linked real world ... will lead data management, share expertise regarding real world evidence (RWE)/ claims data and statistical analyses activities for healthcare research studies for… more
- ManpowerGroup (Chesapeake, VA)
- …projects are completed on time. + Assist with project administration, including managing claims and daily insurance functions. + Create and maintain project ... Our client, a leader in the insurance industry, is seeking a Project Coordinator to...documents and contracts. + Work closely with the project manager to meet project objectives and deliverables. **What's Needed?**… more
- Humana (Lynchburg, VA)
- **Become a part of our caring community and help us put health first** The Provider Relations Representative (Provider Engagement Professional 2) is responsible for ... in this role should have critical thinking/problem solving skills, understanding of health plan operations, and strong interpersonal skills. + Serve as primary… more
- Elevance Health (Norfolk, VA)
- …strategies. + Strong knowledge of medical terminology, codes, and health insurance policies. + Proficient in using claims processing software. Please be ... process improvement, project coordination in a high-volume managed care operation ( claims , customer service, enrollment and billing); or any combination of education… more
- Elevance Health (Norfolk, VA)
- …Experiences:** + Proficiency with MS Outlook, Word and Excel. + Experience in health insurance reimbursement, medical billing, medical coding, auditing, or ... considered. **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined… more
- Elevance Health (Norfolk, VA)
- …week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations._ Carelon Payment Integrity is a proud member of the Elevance ... Health family of companies, Carelon Insights, formerly Payment Integrity,...dollar volume of provider. + Analyzes data to select claims to be reviewed, conducts reviews using medical charts,… more
- Elevance Health (Richmond, VA)
- …week. The **Provider Reimburse Admin Sr** ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... with Federal and state mandates. + Works with other departments on claims adjudication workflow development and business process improvements. + May lead the… more
- Elevance Health (Norfolk, VA)
- …procedures. + Develops and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance ... and/or Dental Vendors is strongly preferred. + Experience with 837P and 837D claims /encounters is strongly preferred. + Advanced knowledge of Excel and SQL is… more