- Elevance Health (Norfolk, VA)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... submitted DRG. **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in… more
- Sedgwick (Alexandria, VA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance IT Project Management Advisor **PRIMARY PURPOSE OF THE ROLE** : Manages software ... Sedgwick's Client Facing Applications (viaOne, mySedgwick and Smart.ly). The project manager is responsible for organizing, defining, and overseeing all facets of… more
- Elevance Health (Roanoke, VA)
- …the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How ... audits. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment &… more
- Sedgwick (Norfolk, VA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance IT Project Management Specialist Sr **PRIMARY PURPOSE OF THE ROLE** : Manages ... Sedgwick's Client Facing Applications (viaOne, mySedgwick and Smart.ly). The project manager is responsible for organizing, defining, and overseeing all facets of… more
- Elevance Health (Norfolk, VA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- USAA (Chesapeake, VA)
- …P&C Litigation Claims Operations and/or Optimization experience. + 2+ years Manager , Claims Operations experience. + Deep operational knowledge of end-to-end ... assistance is not available for this position. **These positions will support Claims Litigations.** **What you'll do:** + Develop and implement strategic customer… more
- Elevance Health (Norfolk, VA)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- UIC Government Services and the Bowhead Family of Companies (Alexandria, VA)
- …Network Architects + Cyber Security Engineer + Cybersecurity Information Systems Security Manager (ISSM) + Data Architect + Data Scientists + Data/Program Management ... Computer Administrator + Power BI- Platform Developer + Product Manager + Program Manager Lead + Project...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Walgreens (Quinton, VA)
- …systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. ... efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory...Follows- up with insurance companies as well as medical providers and participates… more
- Walgreens (Lebanon, VA)
- …systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. ... efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory...Follows-up with insurance companies as well as medical providers and participates… more