- CVS Health (Boston, MA)
- … to members as well as navigating them through the health system, providing support on claims issues, and answering coverage-level questions. **We have two of ... any benefits related issues including answering routine questions, addressing denied claims , preauthorization, and providing support to both the employees… more
- Momentive Performance Materials Inc. (Niskayuna, NY)
- …Summary:In this role, you will be the primary contact for customer support -related activities. You will provide best-in-class or excellent customer service for ... and play a key role as a profitability driver by offering proactive support to sales and customers, ensuring the execution and exceeding of customer expectations… more
- Humana (Columbus, OH)
- …community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to ... support modeling, reporting, and decision-making. Requires strong project management...transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work… more
- AIG (Chicago, IL)
- …for AIG's major insurance operating companies, globally. We collaborate with Finance, Claims , Operations, Marketing and Risk Management, among other functions. As an ... dynamic work projects such as profitability studies, predictive modelling, planning support , and building out portfolio management & monitoring tools. The individual… more
- AmeriHealth Caritas (Washington, DC)
- …by AMC and Plan. + Ensures provider contracting is consistent with claim payment methodologies. + Maintains familiarity with State Medicaid fee schedules and ... of electronic strategies for provider network to include increasing electronic claims submission and implementation of improved processes that result in increased… more
- PRGX (Grand Rapids, MI)
- …statements, freight charges, and buyer files. + Prepare and document audit claims with accurate support , ensuring compliance with internal and client-specific ... + Communicate with vendors to provide supporting documentation, and where applicable, seek claim pre-approvals. + Package and present claims to vendors and/or… more
- Commonwealth of Pennsylvania (PA)
- …Ebensburg Center. You will address self-care, socialization, and health maintenance needs to support each resident's Individual Support Plan (ISP). You will also ... for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (ie,… more
- Commonwealth of Pennsylvania (PA)
- …contributions can profoundly enhance the quality of life for those who require support the most. Your commitment to nurturing and understanding will be instrumental ... of determining your eligibility for the position. Information to support your eligibility for the position must be provided...Select the Level of Performance that best describes your claim . + A. I have experience performing basic self-care… more
- Manulife (NC)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... + Acquires and reviews internal / external documents to support investigative activity and findings + Conducts interviews of...and trains more junior investigators on long term care claim cases and processes + Ability to travel on… more
- Manulife (FL)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... + Acquires and reviews internal / external documents to support investigative activity and findings + Conducts interviews of...and trains more junior investigators on long term care claim cases and processes + Ability to travel on… more