- Citizens (Johnston, RI)
- …As the Consumer QA QC Sr. Specialist you will work to understand, monitor and process requests that relate to high risk or complex processes. You will work within ... established procedures with a moderate degree of supervision. Your goal is to prevent risk to the bank or our customers by handling these requests timely, diligently and completely to ensure that you identify any errors that occurred in the process and ensure… more
- Humana (Juneau, AK)
- …The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national ... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion… more
- Guidehouse (San Marcos, CA)
- …of patient confidentiality. + Convey empathy and compassion to those experiencing pain, physical or emotional distress and/or grief. + Relate to others in a manner ... which creates a sense of teamwork and cooperation. + Communicate effectively with people from every socioeconomic, cultural and educational background. + Exhibit flexibility and cope effectively in an ever-changing, fast-paced healthcare environment. + Perform… more
- Waystar (Louisville, KY)
- …The Sr. Product Manager will coordinate with key stakeholders in sales, marketing, design, development, and operations. This role will be charged with leading game ... changing efforts at Waystar within the company's Product team for new to market and existing solutions. **WHAT YOU'LL DO** + Analyzing various product inputs, customer requirements, designing solution architectures and developing the business case for new… more
- Deloitte (Jacksonville, FL)
- …+ Support Epic enterprise implementation for a large academic medical center and health system in the Southeast region. + Conduct Epic Hospital Billing application ... Are you an experienced, passionate pioneer in technology? An industry solutions professional who wants to work in a collaborative environment. As an experienced Epic Resolute Hospital Billing Analyst Project Delivery Specialist, you will have the ability to… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …Individualized professional and personal growth is a primary focus at CPHL. With various teams to match the unique strengths of each individual, tiered roles to ... support the advancement, and with opportunities for cross-training and education, CPHL is the place for a fulfilling long-term career. Position Details: + Professionally handle incoming inquiries via telephone, email or fax from providers (ie physician… more
- Sedgwick (Eden Prairie, MN)
- …and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; ... coordinates investigative efforts, thoroughly reviews contested claims , negotiates return to work with or without job accommodations, and evaluates and arranges… more
- MyFlorida (Tallahassee, FL)
- …OPPORTUNITY DIVISION: DIVISION OF RISK MANAGEMENT BUREAU: STATE LIABILITY AND PROPERTY CLAIMS CITY: TALLAHASSEE COUNTY: LEON SPECIAL NOTES: Requirements: + One (1) ... years' experience in the insurance field or adjusting liability claims . + Proficient in using Microsoft Word and Excel....Risk Management Information System, Insurance Management system, or similar claims database. + Currently have or have held a… more
- USAA (Philadelphia, PA)
- …and framework, investigate, evaluate, negotiate and settle complex property insurance claims presented by or against our members. You will confirm/analyze coverage, ... adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to...travel outside of their local territory to respond to claims in other regions when needed. This is an… more
- Insight Global (Nottingham, MD)
- …discrepancies, and initiating corrective actions with payers. This team focuses on facility claims only, and this role is focused only on outpatient claims ... issues, coding issues, misinterpretation of contract issues, etc.). Primary Responsibilities: Claims Management: * Take ownership of outpatient hospital claims … more