- MTA (New York, NY)
- …opportunities. Position Objective: Under the supervision of the Unit Chief, Senior Associate Counsel and MTA Bridges and Tunnels ("TBTA") General Counsel, with ... Risk and Insurance Management, and other MTA Departments and subsidiaries in claims /litigation by contractors and third parties. + Assists relevant MTA Departments… more
- Ortho Sport and Spine Physicians (Atlanta, GA)
- …Translate patient information and alphanumeric medical code entries. Electronic "clean" claims submissions to Insurance Carriers. Collect, post, and manage patient ... for all procedures. Follow Up on accepted or denied claims . Review denied claims for denial reasons...organizational abilities. Productivity Driven. EDUCATION AND EXPERIENCE: High School, Associate Degree or 1-3 years of Billing and Coding… more
- Humana (Oklahoma City, OK)
- …investigations into allegations of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud ... outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Assist in developing FWA education to train staff,… more
- Walworth County (Elkhorn, WI)
- …reimbursement from State and other agencies for DHHS services, managing the claims process to maximize reimbursement. Timely prepares all monthly, quarterly and ... annual fiscal reports/ claims for HHS federal and state funding. Participates in...Knowledge of budget, governmental accounting and/or Human Services accounting preferred . + Knowledge of computer system capabilities as they… more
- W. R. Grace (Columbia, MD)
- …a Counsel, Litigation and Compliance to join our Legal team. Reporting to the Associate General Counsel, Labor & Employment and Compliance, with a dotted line to the ... This attorney will be instrumental in navigating a complex portfolio of claims and litigation matters, including personal injury claims and commercial… more
- Humana (Boise, ID)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …or patient experience setting; healthcare or pharmaceutical experience is strongly preferred (such as insurance verifications, claims , etc.). Skills: Advanced ... assistance programs. This includes call center services (inbound and outbound) and claims processing operations. They are part of a highly concierge "white glove"… more
- Access Dubuque (Dubuque, IA)
- …with regulatory and jurisdictional requirements. + Monitor captive performance, analyze claims data, and recommend adjustments to optimize risk financing strategies. ... Finance, Insurance, or a related field (advanced degree or CPCU/ARM designation preferred ). + 5+ years of experience in P&C insurance, risk management, or… more
- Otsuka America Pharmaceutical Inc. (Indianapolis, IN)
- …new technologies to maximize development efficiency **Qualifications** + 4-year degree preferred relevant experience will be considered + 10+ years of professional ... creating event-driven architectures + AWS Certified Solution Architect - Associate or higher **Bonus Qualifications/Experience** + AWS Certified Solutions Architect… more
- US Tech Solutions (Columbia, SC)
- …+ Experience in case management or care coordination and telephonic care experience is preferred . + A typical day would be managing a case load of members ... provides health management program interventions. + Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to… more
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