- CenterWell (Raleigh, NC)
- …the Branch Coordinator is to provide clerical support for the branch medical records and billing department. Also, responsible for day-to-day coordination of ... computer programs as appropriate. . Complete End of Period claim workflow as part of Billing Specialist responsibilities. This...to ensure other billing requirements are satisfied to release claims timely. . Adhere to and participate in Agency's… more
- Highmark Health (Raleigh, NC)
- …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- UNC Health Care (Kinston, NC)
- …posting, patient accounts receivable management and follow up, charge entry, EDI/ claim submission/ claims rejections, and external collection activities. Provides ... DME Billing Manager oversees the day-to-day operations of Down East Medical Supply's revenue cycle process including referral intake, billing, collections,… more
- Deloitte (Raleigh, NC)
- …and business terms) with PBMS + Experience performing analytical analysis of medical & pharmacy claims , including understanding financial impact of network ... emerging trends and cost drivers + Work directly with medical and PBM vendors to analyze the program offering...providers in such projects as provider network development, operational claim reviews, etc. The team Deloitte's Government and Public… more
- Fujifilm (Raleigh, NC)
- …be an integral part of the legal team providing support to the Medical Device businesses of FUJIFILM Healthcare Americas Corporation and FUJIFILM SonoSite, Inc., ... (HLUS). The Senior Counsel, reporting to the Division General Counsel, Medical Devices, will be an experienced commercial transactions lawyer, responsible for… more
- Elevance Health (Winston Salem, NC)
- …of claims . Works with other Medicare Administrative Contractor (MAC) Medical Directors for developing collaborative policies. May participate in MAC policy ... ** Medical Director- Medicare Fee for Service** Location: This...and Medicaid Services to transform federal health programs. The ** Medical Director** is responsible for drafting and developing policies… more
- Humana (Raleigh, NC)
- …help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the… more
- Humana (Raleigh, NC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- Centene Corporation (Charlotte, NC)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... flexibility. **Position Purpose:** **:** Supports health plan operations through medical management, quality improvement and/or credentialing functions for the… more
- Humana (Raleigh, NC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more