- State of Massachusetts (Worcester, MA)
- …written and oral translation duties, in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational or ... rehabilitation counseling. /*_Preferred Qualifications:_*/ ** * Knowledge of specific local office procedures and requirements. * Knowledge of continuing changes in laws, rules, regulations, programs, policies, procedures, specifications, standards and… more
- CVS Health (Richardson, TX)
- …This position works closely with other technical leaders of the PBM space & Claims Adjudication team to assess business goals, strategic objectives and to build ... a comprehensive and achievable multi-year roadmap for myPBM teams. We are seeking candidates who are passionate to collaborate very closely with Business Stakeholders, Value Pool Product Managers/Owners and Engineering teams in different development… more
- Robert Half Technology (New York, NY)
- …healthcare industry. * At least 2 years of experience with validation processes, claims adjudication , or hospital bill audits. * Strong knowledge of compliance ... frameworks such as HIPAA, HITRUST, and healthcare audit practices. * Proficiency in Microsoft Project, Excel (including pivot tables), PowerPoint, and Word; familiarity with Power BI is advantageous. * Understanding of DRG coding and payment integrity… more
- CVS Health (Hartford, CT)
- …updates provider demographic and contract information in appropriate systems to support claims adjudication and provider directories. + Follows area protocols, ... standards, and policies to provide effective and timely support. + Coordinates with internal/external constituents to implement new networks and complex contractual arrangements. + Communicates directly with providers and/or outside vendors to clarify data… more
- State of Massachusetts (Holyoke, MA)
- …part-time, professional experience in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational ... or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. SUBSTITUTIONS: - A Bachelor's or higher degree may be substituted for two years of the required experience on the basis of two years of education… more
- State of Massachusetts (Roxbury, MA)
- …written and oral translation duties, in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational or ... rehabilitation counseling. /*_Preferred Qualifications:_*/ . Knowledge of specific local office procedures and requirements. . Knowledge of continuing changes in laws, rules, regulations, programs, policies, procedures, specifications, standards, and… more
- State of Massachusetts (Holyoke, MA)
- …part-time, professional experience in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational ... or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. SUBSTITUTIONS: - A Bachelor's or higher degree may be substituted for two years of the required experience on the basis of two years of education… more
- CVS Health (Richardson, TX)
- …This position works closely with other technical leaders of the myPBM space & Claims Adjudication team to assess business goals, strategic objectives and to ... build a comprehensive and achievable multi-year roadmap for the the myPBM teams. This role will be expected to collaborate very closely with Business Stakeholders, Value Pool Product Managers/Owners and Engineering teams in different development environments.… more
- State of Massachusetts (Lawrence, MA)
- …part-time, professional experience in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational ... or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. Based on assignment to second-level supervisory positions, at least one year of this experience must have been in a supervisory capacity.… more
- CVS Health (Richardson, TX)
- …with heart, each and every day. **Position Summary:** As part of the dynamic Claims Adjudication Development Engineering team, you will be expected to be ... proficient in all critical functions of the application development and will champion SDLC methodologies with a deep understanding of best practices to ensure that quality standards are met. This team directly impacts the lives of our pharmacy customers by… more