- Evolent (Little Rock, AR)
- …the manage and report risk , issues, and decisions with the lead / manager + Responsible to attend and if required, lead test team meetings for technical testing ... The IQA reports to a associate director or a manager . One or many IQAs may be engaged in...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Sharecare (Little Rock, AR)
- …eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, ... + Coordinate issue resolution with providers, payers or 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or… more
- CVS Health (Little Rock, AR)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... and the team is highly collaborative. You will report to the Senior Reporting Manager within the PBM Finance Data, Analytics, and Automation team. To be successful… more
- Highmark Health (Little Rock, AR)
- …areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in ... related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges...skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and… more