- Manulife (NH)
- …identify and provide solutions to work related problems and issues (ie Work flow, systems ). + Negotiate and manage time and resources to meet deadlines and service ... process all aspects of auditing, formal appeal reviews and contestable claim review. + Audit applications underwritten to ensure underwriting decisions,… more
- Manulife (ME)
- …identify and provide solutions to work related problems and issues (ie Work flow, systems ). + Negotiate and manage time and resources to meet deadlines and service ... process all aspects of auditing, formal appeal reviews and contestable claim review. + Audit applications underwritten to ensure underwriting decisions,… more
- Helio Health Inc. (Syracuse, NY)
- … and patient access software. + Excellent understanding of Medicaid and Third-party claim procedures for both paper-based and electronic claims . + Strong ... understanding of healthcare regulations, including HIPAA and insurance requirements specific to behavioral health services. + Exceptional communication and interpersonal skills to collaborate with internal and external partners. + Strong computer skills… more
- Quality Technology Services, LLC (Overland Park, KS)
- …project goals. + Provide support in construction-related disputes and claims , including documentation, timeline analysis, and document preparation. + Maintain ... experience is a plus + Ability to learn ERP systems + Excels in a team-oriented work environment +...participate in the investigation of any complaint or discrimination claim . The "Know Your Rights" Poster is included here:… more
- Abbott (Austin, TX)
- …and enrolled in Abbott sponsored clinical trials. + Assist sites with claim submission and appeal processes and other related matters requiring a specialized ... analysis utilizing Medicare data, procedure codes, hospital payment codes and other claims data. + Basic understanding of clinical trial categorizations not limited… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …for the Anesthesiology Service. Oversees the development and implementation of systems redesigns projects, quality improvements and assurance programs of inpatient ... and peer review. Participates in clinical review process such as tort claims , peer reviews, management reviews and administrative activities, as directed by the… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …management, medical, patient access and market access to engage local healthcare systems and identify opportunities to improve the patient experience. Through this ... business plan. This role is accountable for orchestrating engagement with key systems of care to drive collaborative value creation for Otsuka, its customers,… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …maintained and integrated as necessary with each other and/or with other internal/external systems . + Identify system enhancements that will improve process or ... business decisions. + Responsible for maintaining or improving the systems and processes in place, to ensure strong data...+ Create data audit reports and dashboards to ensure system data accuracy. + Support in development of knowledge… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …security goals. This includes operational management of third-party and IT system cybersecurity assurance processes that assess against company standard information ... business and IT to ensure that they assess third parties and IT systems against information security controls. The Cybersecurity Risk Manager also leads the… more
- Post Holdings Inc. (St. Louis, MO)
- …state-equivalent, private, paid leave programs. You will partner with outsourced systems , vendors, and internal departments such as HRIS, Human Resources, Payroll ... managers, and business unit HR partners on leave eligibility, claims payments, and leave impacts on other health &...Experience with Ultimate Software (UKG) or other HR software systems This is a hybrid role based in St.… more