- University of Utah Health (Murray, UT)
- …for customer service performance expectations. + Explains adjudication of claims for allocation of deductibles, co-pays, co-insurance maximums and provider ... to members, providers, billing departments and other insurance companies regarding claims , benefits and eligibility, provider network status, and any other related… more
- City of New York (New York, NY)
- …critical services effectively and meet DOHMH's objectives. Reporting to the Director of Miscellaneous Revenue and Compliance. The candidate will be responsible ... payments in compliance with financial policies and procedures. - Examine invoices, claims , fee collection or applications for recoupments, refunds and verify their… more
- UPMC (Pittsburgh, PA)
- …quality of service, assist the provider in developing action plans, support claims /payment inquiries, and support ongoing provider education. Work with a broad ... + Manage special projects assigned by manager and department director . + Meet deadlines and turnaround times set by...key UPMC depts, ie; Service Coordination, Provider Monitoring, FWA, Claims , etc. + Assist providers to resolve issues related… more
- Stanford University (Stanford, CA)
- …as they develop their careers and enrich their lives. Reporting to the Global HR Director and in partnership with the Senior Director of Benefits, the Global ... cost and performance, and ensure accurate and timely plan administration, claims payment, manage escalated issues, etc. + Manage monthly billings, enrollments,… more
- CVS Health (Downers Grove, IL)
- …to support staff. + Process Improvement: Work with Sr. Managers and Director to develop and implement strategies to streamline, policies, procedures, provider ... well as for internal staff that aligns PE/Network functions with Operations and Claims as needed + Research, review, and prepare responses for all governmental,… more
- UIC Government Services and the Bowhead Family of Companies (Springfield, VA)
- …provided by Suitability Executive Agent (SuitEA) and Office of the Director of National Intelligence (ODNI). * Receives completed investigations and inquiries ... by Suitability Executive Agent (SuitEA) and Office of the Director of National Intelligence (ODNI). * Apply proper grammatical...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- AON (New York, NY)
- …position will have frequent interactions with the client Human Resource/Benefit Director for the delivery of benefits consulting services. Responsibilities include ... State and Federal requirements + Analysis of utilization reports, carrier reports, and claims data & trends. + Possess a strong understanding of the health and… more
- University of Utah Health (Murray, UT)
- …risk adjustment program. + This role is responsible for analyzing medical claims , encounter, and risk adjustment targeting data to identify opportunities for ... data. + Ability to perform complex research and analysis of healthcare claims , enrollment, and other related data, to report on network utilization, cost… more
- Cedars-Sinai (Beverly Hills, CA)
- …with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the ... before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director /Medical Director to research any issues (ie contract,… more
- University of Utah (Salt Lake City, UT)
- …Dr. Kumar's research focuses on health service research, utilizing Medicare claims data, epidemiological data, qualitative data analysis, and electronic health ... with data management of large survey, state, health system, and Medicare claims data * Proficiency with Microsoft Office, especially Excel. * Data collection,… more