- Cardinal Health (Hagatna, GU)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... gaps + Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted HCPs/accounts touched)… more
- Health Care Service Corporation (Chicago, IL)
- …regarding the delegated entity reporting requirements to include claims delegation, utilization management delegation and credentialing delegation.8.Respond to ... provider inquiries in an effective and timely manner and assist in claims resolution and payment problems. Must work closely with the Pricing, Full Service Units,… more
- Philadelphia Insurance Companies (Chicago, IL)
- …control technical support to Tokio Marine departments such as underwriting, claims and coordination. Coordinate loss control activities on select accounts ensuring ... and completed, responding to customer requests and needs and supporting underwriting and claims at renewal and during the policy period. Essential Job Functions: +… more
- DXC Technology (Troy, MI)
- …Customer personnel involving customer products, and processing product warranty claims . Representatives provide technical support and warranty adjudication on heavy ... (US and Canada). The position also includes the processing and verification of warranty claims . Training would be provided on all products and software used in daily… more
- Turner & Townsend (Houston, TX)
- …and client expectations. + Manage post-contract processes including change control, claims evaluation, and final account settlements. + Prepare clear, commercially ... client expectations. + Managing post-contract processes including change control, claims evaluation, and final account settlements. + Preparing clear, commercially… more
- CVS Health (Columbus, OH)
- …analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid regulatory & ... in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data visualization tools… more
- Guidehouse (Chicago, IL)
- …Power BI, Tableau, TIBCO Spotfire or others + Strong understanding of healthcare claims (facility or payer) data and/or HIT applications including those used to ... manage patient, financial, clinical, claims and/or operational data, is a strong advantage + Highly motivated, driven, and dynamic attitude towards work and career.… more
- Philadelphia Insurance Companies (Jersey City, NJ)
- …Respond to customer requests and needs on assigned accounts. Support underwriting and claims at renewal and during the policy period. Coordinate with producers and ... loss control technical support to Tokio Marine departments such as underwriting, claims and coordination. Essential Job Functions + Coordinates loss control service… more
- WellSense (MA)
- …liaison between provider and internal Plan departments such as Provider Enrollment, Claims , Audit, Marketing, Customer Care and Care Management. **Our Investment in ... visit servicing standards** + **Acts as liaison for all reimbursement, credentialing, claims , EDI web site procedures and issues of key providers** + **Facilitates… more
- CVS Health (Columbus, OH)
- …care, and end of life. + 2+ years experienced working with clinical and claims data + Ability to manage multiple customers and competing priorities that drive ... positive outcomes + Experience in the following: + 5+ years experience introducing and implementing programs + Outstanding verbal and written communication skills, including formal presentations for all levels of management combined with strong… more