- Air National Guard Units (Belle Chasse, LA)
- …integrity, efficiency, and reliability of all components of the assigned system . Provides Information Assurance systems support for all disciplines, ... Units (GSU), and Tenants. Plans, coordinates, installs, and continuously analyzes system design, hardware and software. Develops, recommends, and installs solutions… more
- Air National Guard Units (Scott AFB, IL)
- …or configuration related issues associated with a variety of different system platforms, operating systems , applications, and equipment configurations. Work ... correct problems, and distribute workload relative to interface and interoperability of system components such as hardware, systems software, and applications… more
- CVS Health (Sacramento, CA)
- …to the member to determine accuracy/appropriateness of benefit/administrative denial. + Research claim processing logic to verify accuracy of claim payment, ... + At least 2+ years in one of the following areas: claim platforms, products, and benefits; patient management; product or contract drafting; compliance… more
- SSM Health (MO)
- …and Requirements:** PRIMARY RESPONSIBILITIES + Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. ... visit documentation, procedure reports generated from non-the electronic health record systems , etc. + Reviews medical record documentation in the electronic health… more
- US Tech Solutions (Chesapeake, VA)
- …including co-morbid and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case management and eligibility. ... cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and… more
- Actalent (South San Francisco, CA)
- …cross-functional teams. The role involves offering insights on promotional strategy, claim development, labeling alignment, and risk management. As a key regulatory ... and promotion regulations. + Knowledge of FDA evidence standards for promotional claims , including interpretation of clinical trial data and scientific literature. +… more
- National Health Care Associates (Wethersfield, CT)
- …party to generate COBRA notices. + Research, analyze, and resolve eligibility and claims related issues. + Provides consultation to participants and HR on benefit ... Determines and sets up payroll deductions for benefits. + Coordinates disability claim submissions with facility Human Resources and carrier. + Runs various payroll… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …front-end prior authorization, biosimilar drugs, pharmacy-benefit exclusion drugs, and claims . Located in Boston and the surrounding communities, Dana-Farber Cancer ... and coordinatesappealprocess. + Creates cost estimates for waivers. + Rootcauses claim denials, reprocesses, andsubmitsclaim appeals. + Creates drug cost estimates… more
- BrightSpring Health Services (Denver, CO)
- …onboarding and maintaining employee records + Managing purchasing and communication systems + Providing general office and administrative support + Coordinating with ... teams on medical records, data entry, and claims + Assisting with personnel processes to ensure efficiency...supervision + Assist with billing processes to support timely claim submission and minimize denials + Participate in internal… more
- Aston Carter (Valencia, CA)
- …+ Bachelor's degree preferred or equivalent relevant experience. + Proficiency in CRM systems , insurance claim processing software, and Microsoft Office. + Sales ... customer service. + Obtain necessary documentation and submit insurance claims accurately. + Handle referral authorizations, pre-service appeals, and denials… more
Recent Jobs
-
Engineer 3 with Fleet EV Center of Excellence
- Southern California Edison (Pomona, CA)