- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …synthesizes data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals. Their work goes beyond extraction; it ... as Network and Pharmacy, ensuring data is pulled using the most representative methods. They also support high-risk regulatory reporting, where precision and speed… more
- Ford Motor Company (Albany, NY)
- …for the balance of the book . Proactively monitor key underwriting and claims metrics to identity emerging risks and opportunities . Collaborate with underwriting ... and underwriting experience and performance targets . Ford Pro Insure representative on Underwriter Committees, North American Statutory Boards, and Corporate… more
- Guidehouse (San Marcos, CA)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** Up to 10% **Clearance Required** **:** None **What You Will Do** **:** The **Team Lead ... office and three days from home._** + **Strong Hospital Claims A/R, Cash Posting & Credit Balance skills** +...company and client standards + Strong understanding of all software/ systems used + Identify, validate, and report project trends… more
- Towne Park (Plymouth Meeting, PA)
- …Manages day-to-day administration of benefits programs, including enrollment, claims resolution, and compliance. Supports internal communications and employee ... engagement and understanding of benefits. 25% Ensures adequate processes, systems , and audits are in place to maintain compliance...15% Develops and monitors KPIs related to benefits and claims to manage risk and vendor performance and analyzes… more
- New York eHealth Collaborative (New York, NY)
- …large and complex datasets (eg, master patient indexes, SPARCS, healthcare claims ). + Design, implement, maintain, and enhance data workflows, ETL/ELT pipelines, ... audiences. + Familiarity with Clinical Quality reporting, Medicare and Medicaid claims data, ICD coding, CDA standards, web scraping, EHR/EMR systems… more
- Pedernales Electric Cooperative (Johnson City, TX)
- …the UC mapping system + Participate in the process for damage claims + Resolve customer complaints and answer customers' questions + Provide employees with ... the operation, maintenance, construction and repair of transmission and distribution systems . Essential Duties & Responsibilities + Demonstrate mastery and continue… more
- Priority Health Care (Gretna, LA)
- …being followed and patient data is entered into the practice management system timely and accurately. The position entails answering a multi-line phone; scheduling ... plans. + Complete benefit verification with the electronic medical record's (EMR) system . + Assist patients in completing patient history forms, consent forms, and… more
- HUB International (Tulsa, OK)
- …Provides benchmarking reports to client (annually, quarterly, or monthly) + Manages claims and coverage issue resolution for clients' employees when elevated from HR ... Manages new carrier, plan or vendor implementation including benefits administration system build-out and project management + Installs and regularly updates client… more
- Sysco (Harmony, PA)
- …perform each essential duty listed below. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may ... (HR) processes (eg coordinate and conduct new associate orientation, unemployment claims processes, onboarding and exit interviews, transitional return to work,… more
- Hart Medical Equipment (Grand Blanc, MI)
- …Ensures the Certificate of Medical Necessity is completed to release claims . ESSENTIAL DUTIES AND RESPONSIBILITIES: Reasonable accommodations may be made to ... guidelines have been met. + Creates Certificate of Medical Necessity within the system to encompass all billable items and qualifying diagnoses. + Assists with… more