- 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
- USAA (Tampa, FL)
- …evaluate, negotiate, and settle low to moderate complexity property insurance claims . You will confirm/analyze coverage, recognize liability exposure and negotiate ... this position. **What you'll do:** + Proactively manages assigned claims caseload comprised of claims with low...Proactively manages assigned claims caseload comprised of claims with low to moderate complexity damages that require… more
- USAA (Colorado Springs, CO)
- …impactful. **The Opportunity** **It is all about learning and growing.** Our Entry Level Auto Claims Adjuster role may be a new career for you. There's a lot to ... Colorado Springs, CO 80920)** as a Entry Level Auto Claims Adjuster. Your work will focus on adjusting non-injury...Adjuster. Your work will focus on adjusting non-injury auto claims and you'll work under supervision to investigate, evaluate,… more
- Sedgwick (West Hills, CA)
- …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
- Commonwealth of Pennsylvania (PA)
- …and notifying relevant parties of DHS interest. You will initiate requests for medical claims for review and follow-up to ensure payment of the claim. In this role, ... + Credits/Clock Hours 10 WORK BEHAVIOR 2 - INVESTIGATES PERSONAL INJURY CLAIMS AND THEIR ESTATES Investigates medical assistance recipients' personal injury … more
- USAA (San Antonio, TX)
- …guidelines and framework, you are responsible to adjust moderately complex auto insurance claims presented by or against our members to include the end-to-end ... claims process and settling claims in compliance with state laws and regulations. You are accountable for delivering best in class service, through setting… more