- Mass Markets (NE)
- …and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- The Cigna Group (Bloomfield, CT)
- …EBM, ICD10, CPT4, DRG, etc.), systems, case-mix adjustment, and applications for claims payment, providers, and utilization management. + Expertise in the use of ... meeting aggressive deadlines + Comprehensive understanding of claim submissions claims payment processes, reporting concepts, database management, and financial… more
- The Cigna Group (Raleigh, NC)
- …**Qualifications** : + 5 years of experience with healthcare data domains (eg, medical claims , pharmacy claims , eligibility) + 5 years of experience with cloud ... tools and building data pipelines (particularly in Databricks) + 3+ years of experience with Python scripting + 5+ years of experience in SQL for data extraction, manipulation, and analysis + Proficiency in Tableau or Power BI If you will be working at home… more
- The Cigna Group (Bloomfield, CT)
- …skills, experience with Databricks and GitHub a plus + Knowledge of Cigna claims systems and/or standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, ... and HCPCS strongly preferred + Strong analytical and problem-solving skills with a proven track record of success + Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines + Highly organized and… more
- Walmart (Wilkes Barre, PA)
- …and merchandised according to company policies, including proper handling of claims , returns, shrink, and damages. Presents and maintains merchandise presentation by ... stocking merchandise, setting up, cleaning, and organizing product displays, removing damaged goods, signing and pricing merchandise appropriately, and securing fragile and high-shrink merchandise. Monitors the status of tire and battery orders daily and… more
- Pacific Air Forces (GU)
- …most complex, often precedential, installation level cases in administrative law, claims , environmental law, contract law, labor law, international law, and ... operations law to the 36 Wing and tenant units. Responsibilities As a senior attorney, advises the 36 WG Commander, as well as subordinate and tenant unit commanders and managers, on a host of general law matters. For the most complex installation legal… more
- Centene Corporation (Springfield, IL)
- …improve provider performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Identifies specific practice needs where Centene can ... provide support. + Develops, enhances and maintains provider clinical relationship across product lines. + Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. + Ability to travel up to 75% of time… more
- Compass Group, North America (NC)
- …avoid litigation. + Manages the associates appeal process for all denied leave claims . + Keeps unit managers, Human Resources, and Benefit Team abreast of associates ... leave approval status. + Educate employees and managers on complicated aspects of the return to work, leave accommodation, and complex case processes. + Escalate Complex issues including inability to accommodate, transitional work programs for guidance. +… more
- CARMAX (Norwood, MA)
- …♦ Obtain accurate estimates and approvals for Extended Service Policy (ESP) claims . ♦ Consult with customers regarding needed repairs. ♦ Review repair orders ... for work performed and accuracy of all labor, parts and sublet documentation for billing. . ♦ Close and invoice repair orders. ♦ Clearly explain and communicate all recommendations/repairs/service/maintenance performed to ensure customer understanding. ♦… more
- Centene Corporation (Surfside Beach, SC)
- …improve provider performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Identifies specific practice needs where Centene can ... provide support. + Develops, enhances and maintains provider clinical relationship across product lines. + Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. + Ability to travel up to 75% of time… more