- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
- Highmark Health (Richmond, VA)
- …to accepted and established coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of ... claim review with the goal of proper and timely payment to provider and member satisfaction. The incumbent is...claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure… more
- Elevance Health (Ashburn, VA)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer reimbursement ... **Be Part of an Extraordinary Team** Carelon Payment Integrity is a proud member of the...Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. **Build the Possibilities. Make an Extraordinary Impact.**… more
- Elevance Health (Richmond, VA)
- …assurance environment preferred. + Broad, deep and niche knowledge of medical claims billing/ payment systems provider billing guidelines, payer reimbursement ... for employment, unless an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies,… more
- Elevance Health (Richmond, VA)
- ….Experience working with ICD-9/10CM, MS-DRG and APR-DRG. .Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer ... an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance...Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Managers of DRG Coding & Clinical… more
- Amazon (Arlington, VA)
- …Bid/Capture team. The position will have primary responsibility of contractual payment obligations across the diverse Amazon Business B2B portfolio of agreements. ... Responsibilities will include contract interpretation, external customer communications, internal payment process ownership, sharing of best practices, and process… more
- Elevance Health (Richmond, VA)
- **Business Consultant -** **Carelon Payment Integrity** **Location** : This role requires associates to be in-office **1-2** days per week, fostering collaboration ... for employment, unless an accommodation is granted as required by law._ **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies,… more
- Elevance Health (Richmond, VA)
- …performing medical reviews via prepayment claims review and post payment auditing + Correlates review findings with appropriate actions (provider education, ... **Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This...Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Nurse Audit Senior** will be responsible… more
- Bank of America (Richmond, VA)
- Operations Analyst - 2nd Shift - Global Payment Operations Richmond, Virginia;Scranton, Pennsylvania **To proceed with your application, you must be at least 18 ... at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Richmond/Operations-Analyst 2nd-Shift Global- Payment -Operations\_26000080) **Job Description:** At Bank of America, we are… more
- Elevance Health (Norfolk, VA)
- ** Payment Integrity Business Analyst III** **Hybrid** : This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and ... for employment, unless an accommodation is granted as required by law. The ** Payment Integrity Business Analyst III** is responsible for reviewing and analyzing … more