- Fairview Health Services (Minneapolis, MN)
- …Administer revenue capture analysis and report by validating reimbursement and investigating claims . + Assist manager in third party payer reimbursement appeals. ... financial reporting, data analysis financial planning, contract proposal evaluations, claims payment accuracy reconciliation and pharmacy payer contract liaison… more
- The Hartford (Stamford, CT)
- …both internal and external partners including Brokers, Reinsurers, Cedents, Legal, Actuarial, Claims , Underwriting, Operations , Vendors and/or IT, to achieve the ... Reinsurance (NavRe) organization is looking to transform our treaty underwriting and operations activities both now and into the future. Reporting to the NavRe… more
- HCA Healthcare (Denver, CO)
- …Risk Management with HCA HealthONE Presbyterian St. Luke's, you can be a manager in an organization that is devoted to giving! **Benefits** HCA HealthONE ... Committee and Board of Trustees. Include the patient's story of harm. Risk Management/ Claims Activities (if not otherwise assigned) . Work with defense legal counsel… more
- Corewell Health (Grand Rapids, MI)
- …Federal decisions are properly implemented. Assist the Lead, Supervisor and/or Manager in coordinating activities and in the development/collection of materials ... (external medical records, internal documentation from enterprise-wide systems including: claims payments, billing and enrollment, care management, medical, pharmacy… more
- Elevance Health (Richmond, VA)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you ... fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing + Correlates review...and educational materials + Acts as liaison with service operations as well as other areas of the company… more
- Gentiva (Mooresville, NC)
- …our billing operations through timely processing of Government and Commercial claims . This role plays a vital part in maintaining accurate medical records, ... **Overview** **Streamline Claims . Ensure Accuracy. Support Quality Care.** We are...trends and report unexpected patterns to the Revenue Cycle Manager . + Participate in quality improvement activities related to… more
- Bristol Myers Squibb (Princeton, NJ)
- …entity relationships + Experience managing and transforming 340B-related data (eg, claims , chargebacks, rebates) + Demonstrated success leading operations , ... Optimization & Analytics Lead manages a team executing day-to-day operations of the 340B Center of Excellence (COE) including...expectations for teams outside of the 340B COE (eg, claims processing) ensuring teams are properly trained and execute… more
- Corewell Health (Grand Rapids, MI)
- …and FFD program and practices within Corewell Health. + Assists the manager in planning, leading, collaboration and representation for the day-to-day operations ... compliance with Federal, State regulations and Corewell Health plans. Assists manager with payroll duties. Completes the performance snapshot and annual performance… more
- Stanford Health Care (Palo Alto, CA)
- …Senior Specialist independently performs advanced analysis of pharmacy billing and claims data to identify discrepancies, compliance gaps, and emerging reimbursement ... will do** + Independently reviews and analyzes complex Pharmacy billing and claims data to identify discrepancies, compliance issues, and reimbursement risks across… more
- Zurich NA (New York, NY)
- …Underwriting Mgr or AVP, Underwriting Mgr- Middle Market Level. The hiring manager will determine the appropriate level based upon the selected applicant's ... for this position. **Basic Qualifications:** Associate Middle Markets Underwriting Manager : + High School Diploma or Equivalent and 5...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more