- CenterWell (Hiawatha, IA)
- …HCHB and computer programs as appropriate. + Complete End of Period claim workflow as part of Billing Specialist responsibilities. This includes confirming all ... to ensure other billing requirements are satisfied to release claims timely. + Adhere to and participate in Agency's...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Elevance Health (Louisville, KY)
- …analytical support to the Cost of Care organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... and specialty care procedures and recommends policy changes and claim 's system changes to pursue cost savings. + Reviews...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- US Tech Solutions (Chesapeake, VA)
- …enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face and telephonically assessing, planning, ... including co-morbid and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case management and eligibility.… more
- Unum Group (Chattanooga, TN)
- …a "single point of contact" for the employer to assist understanding of individual claim or leave status as well as providing consulting and education on disability ... to ADA, integrated leave management procedures, FMLA process, and STD/LTD claims management. + Provides consultation and education to customer about individual… more
- New York State Civil Service (New York, NY)
- …attorneys and contact employers about potential resolution of callers' claims /complaints.* Assist in identifying inquiries/complaints received by the bureau in ... point of contact for FIFA complainants, gather information and documents to assess the claim and whether a violation of the law may have occurred. * Send… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …front-end prior authorization, biosimilar drugs, pharmacy-benefit exclusion drugs, and claims . Located in Boston and the surrounding communities, Dana-Farber Cancer ... overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + Monitors email communication to the Drug… more
- Geisinger (Danville, PA)
- …providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and ... complete and accurate coding. + Communicates to Coding Quality and Professional Manager any new diagnoses, procedures, technologies, etc. + documented within patient… more
- Bechtel Corporation (Chandler, AZ)
- …preparation of documents and the management of subcontracts + Assists Subcontract Manager or more senior Subcontract Professionals in completion of the various tasks ... formation and post award changes. + Knowledge of risk and insurance provisions, claim preparation, and resolution strategies in coordination with legal and claims… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- …the resume submitted and qualified candidates will be referred to the hiring manager every 2 weeks. Responsibilities The Minneapolis VA Health Care System is seeking ... and peer review. Participates in clinical review process such as tort claims , peer reviews, management reviews and administrative activities, as directed by the… more
- GE Vernova (Boston, MA)
- …to PMO Sourcing team. + Ensures appropriate marine operations risks, contracts and claim management awareness and know-how in his/her unit. + Has the authority ... together with the GEV projects sourcing manager to negotiate Frame Agreements, Purchase Orders conditions within its scope of responsibility and manage contracts… more
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