- Humana (Boston, MA)
- …beneficiary, provider, and Government inquiries regarding eligibility, enrollment, billing, claims , referrals/authorizations, network operations , access to care, ... to correct multifaceted problems relating to eligibility, enrollment, billing, claims , referrals/authorizations, network operations , access to care, Defense… more
- USAA (Chesapeake, VA)
- …systems to collect and analyze data. **What sets you apart:** + P&C Litigation Claims Operations and/or Optimization experience. + 2+ years Manager, Claims ... assistance is not available for this position. **These positions will support Claims Litigations.** **What you'll do:** + Develop and implement strategic customer… more
- Xeris Pharmaceuticals, Inc. (Chicago, IL)
- …disease and/or biotech industry experience preferred + Experience with specialty pharmacy claims and data operations + Self-starter who anticipates challenges, ... of primary/secondary insights + Leverage syndicated data (eg, IQVIA, claims data) and internal data assets to develop a...business rules used to issue product alerts based on claims data + Respond to and develop solutions for… more
- Elevance Health (Atlanta, GA)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you ... fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing + Correlates review...and educational materials + Acts as liaison with service operations as well as other areas of the company… more
- MyFlorida (Daytona Beach, FL)
- …building, contents, fire, theft, auto and casualty requirements and processing of related claims for incidents / accidents. + This position shall serve as the Safety ... Area to include coordinating safety committees, coordinating and reviewing accident claims , workers comp claims , coordinating corrective actions, safety… more
- HCA Healthcare (Salt Lake City, UT)
- …and Qualifications** Serves as the central point of contact for revenue cycle operations in the PHY Division for our Parallon business partners. Directs and ... company reimbursement analysis. The objective of this position is to streamline operations and improve revenue cycle metrics through detailed analysis and process… more
- Hensel Phelps (Greeley, CO)
- …complex legal issues and disputes. + In conjunction with Legal and Senior Operations management, manage and direct all aspects claims , disputes, and litigation ... construction projects. Corporate Counsel will also be responsible for managing claims , disputes, and litigation involving the Company, including government claims… more
- SpartanNash (Byron Center, MI)
- …and regulatory compliance. Provides guidance, coaching and direction to retail operations management based on company policies and procedures, and partners with ... appropriate. Investigate and recommend action to be taken, and participate in claims hearings as necessary, regarding unemployment compensation claims , workers… more
- Robert Half Management Resources (Jacksonville, FL)
- …closely with healthcare revenue cycle processes to ensure accurate medical billing and claims management. If you have experience in healthcare revenue cycles and a ... cycle processes to optimize efficiency and accuracy. * Manage medical billing operations , ensuring timely and accurate processing. * Handle medical claims … more
- The Hartford (Hartford, CT)
- …solutions that deliver measurable value. + Claims Knowledge: Strong familiarity with claims operations in P&C or Group Benefits is highly preferred. + ... technology, and operations teams to co-design scalable, production-ready solutions. + Claims Domain Expertise: Apply a deep understanding of claims processes… more
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