- Prime Healthcare (Riverdale, GA)
- …seeking aRisk and Compliance RN, also known as Risk Management RN. The Risk Manager RN plays a crucial role in ensuring patient safety, reducing hospital liability, ... in risk-related activities in this area + Provides assistance with claims investigation, management and litigation. Facilitates reporting of safety data/events.… more
- Zurich NA (Topeka, KS)
- …+ Direct and manage a team who focuses on customer service and claims oversight provided by strategic TPAs. + Develop, refine and implement business processes ... Service areaAND + 7 or more years of line manager experience in an insurance company and call center...Preferred Qualifications: + People management experience + Life insurance claims experience Your pay at Zurich is based on… more
- CVS Health (Columbus, OH)
- …or intricate healthcare fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares ... on investigations + Serves as back up to the manager as necessary + Cooperates with federal, state, and...+ The ability to understand and analyze health care claims and coding + Ability to travel up to… more
- Consumers Energy (Jackson, MI)
- …for those that qualify). **General Summary of Job Responsibilities** The Manager of Construction Management is responsible for providing leadership, direction, and ... Participate in the negotiation and resolution of select contractor and vendor claims . Participate in the procurement strategies on certain projects + Ensure project… more
- Elevance Health (Norfolk, VA)
- …providing non-clinical review and analysis of non-complex Tier 1 post service medical claims . **How you will make an impact:** + Utilizes guidelines and review tools ... a High School Diploma and a minimum of 4 years of internal company claims processing or customer service experience; or any combination of education and experience… more
- Financial Partners Credit Union (Downey, CA)
- …and/or collateral. + Recommend accounts for legal action or repossession to the manager for approval. + Assign accounts for field chase when necessary. + ... Documentation and Claims : + Review and follow up on letters of...an equivalent combination of education and experience. + An Associate 's degree is preferred. + Proficiency in Windows, Excel,… more
- CenterWell (Boston, MA)
- …Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- City of New York (New York, NY)
- …materials; managing all grant-related activities including expenditures; deliverables, fiscal claims , evaluations, and reporting; and providing guidance to partner ... providing progress reports to the State; handling program audits; and ensuring participating agency claims are paid in a timely manner. The Director will also act as… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …role is key to driving successful IT development initiatives within the Pharmacy Benefits Manager (PBM) claims space. As a Senior Consultant, you will serve as ... our vision of transforming healthcare. As a Blue Cross associate , you are joining a culture that is built...additionally, you will have a strong understanding of PBM claims processing and related technologies. Your Responsibilities * Primary… more
- UIC Government Services and the Bowhead Family of Companies (Travis AFB, CA)
- …certifications + **Mandatory (per PWS):** + Switch Technician with Cisco Certified Network Associate (CCNA) or higher + CompTIA Security + Ability to meet OEM ... Fluke DSX/OTDR certification training. + Familiarity with Cisco Unified Communications Manager (CUCM), E-911, and CAIRS/TMS/CVC database systems. + Intermediate to… more