- Elevance Health (Norfolk, VA)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS… more
- Clark Construction Group, LLC (Mclean, VA)
- …with our in-house legal team and is responsible for managing Clark's claim and litigation docket, leading the Company's eDiscovery process, managing Clark's owner ... contracts. Will also assist in managing task trackers. + Provide support for claims management. + Oversee and manage all elements of the Company's eDiscovery… more
- Elevance Health (Richmond, VA)
- …teams responsible for building, scaling, and maintaining platforms for: + Medical Cost Management ( claims review, payment integrity, utilization management, ... **Staff VP Engineering** - Medical Cost Management & Cost of Care **Location:**...for building advanced analytics platforms, AI/ML-driven decision support tools, claims optimization systems, and clinical insights platforms that enable… more
- Sedgwick (Richmond, VA)
- …external customers; escalates issues to the appropriate parties; provides status and follow up information to internal or external customers; and assists real-time ... of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including… more
- Lowe's (Richmond, VA)
- …for vacations, holidays and sick time, as well as access to top-tier medical , dental and vision insurance. For information about our benefit programs and ... Distribution Centers (BDC). Your day involves reviewing calls, emails, and claims , providing status updates, processing special orders, and monitoring load plans… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …direct care for patients assigned to the Medical Service, ensure continuation of medical care and disposition plans, follow up on pending patient care items. ... looking for a skilled Physician - Hospitalist at the Richmond Veterans Affairs Medical Center in Richmond, Virginia. A Nocturnist Hospitalist can practice all types… more
- CVS Health (Richmond, VA)
- …monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** ... appropriate customers and accounts. + Balance deposits in the accounting system. + Follow systems of checks and balances. + Allocate broker commissions for payment.… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …ineligible to apply. Responsibilities The Geriatrics Transitional Care Program Medical Director may practice in all settings, including inpatient, outpatient, ... are looking for a 1.0 FTEE Geriatric physician as medical director of the transitional care program. Join a...development, quality improvement, and Systems Redesign projects; required to follow through with projects and show evidence of completed… more
- CVS Health (Fairfax, VA)
- …and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops ... including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility.… more
- Maersk (Norfolk, VA)
- …and efficiency * Routinely review the vessel safety committee meeting and initiate follow up. Utilize support in cooperation with other departments as needed. * ... Support in handling and closing out Casualty and /or claims pertaining to P&I or Hull Machinery insurance matters....and their close out until the point of a claim case being prepared for invoicing. * Participate in… more