- Highmark Health (Harrisburg, PA)
- …functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness ... studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving. **ESSENTIAL RESPONSIBILITIES** + Define & diagnose a problem.… more
- WestCare Foundation (Dandridge, TN)
- …the financial and operational health of the organization. Essential Job Functions: + Claim Preparation & Submission: Prepare and submit accurate and timely medical ... claims to insurance companies, government programs, and other payers....allocation of funds. + Denial Management: Review and analyze claim denials, identify the reasons for denial, and take… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in person or ... of the member to facilitate and support the member's improved health. The Case Manager develops a proactive course of action to address issues presented to enhance… more
- CVS Health (Bassett, VA)
- …it all with heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna's Long-Term Services and Supports (LTSS) team ... talking on the telephone, and typing on the computer Nurse Case Manager is responsible for assessing, planning, implementing and coordinating all case management… more
- Walmart (Mccordsville, IN)
- …assigned area of work. Creates action plans to address audit findings. Validates claim records work with worker's compensation case managers for investigation of ... claims . Asset Protection & Security Possesses knowledge of: Asset...and adjusts performance to address findings. Promotes and supports associate efforts to exceed customer/member expectations. Informs associates on… more
- Penguin Random House (Westminster, MD)
- Credit and Collections Associate Bertelsmann Global Business Services operating through Penguin Random House is seeking an experienced **Credit and Collection ... Associate ** to join their team. Under full to moderate...paper mail, email and faxes promptly. + Responsible for claim research and resulting debit/credit adjustments or denials. +… more
- Oak Orchard Health (Brockport, NY)
- Revenue Cycle Manager Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420) Job Type Full-time Description Do you want to be part of a ... the third-party billing organization to ensure proper processing of all payer claims . This would include research for accuracy, analyze reports, follow through… more
- Sysco (Front Royal, VA)
- …abuse form, photos of the load, and applicable TTR report to the RDC Claims Coordinator for product disposition. + Coordinate getting the pallet trailers moved to a ... release outbound loads to dock doors via SWMS Route Manager . + Use Microsoft Teams channel to review the...policies (ie, attendance, Code of Business Conduct and Ethics, Associate Handbook, etc.). + Support food safety policies, standard… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …healthcare services through an interdisciplinary team that includes the PCP, RN care manager , LVN, clerical associate as well as other clinical services ... ECFMG certificate, if claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm that the medical school… more
- CVS Health (Louisa, VA)
- …talking on the telephone, and typing on the computer Nurse Case Manager is responsible for assessing, planning, implementing and coordinating all case management ... including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility.… more