- Virginia Mason Franciscan Health (Tacoma, WA)
- …Delivery Model (CDM) VMMC * Provide clinical expertise related to medical necessity claims Job Title: Physician Advisor Job Code: Dept: * Collaborate on the ... with the segmentation of concurrent review offerings into Medicare / Medicaid / Commercial Payors, as needed * Reviews medical records of patients identified by case… more
- Lundbeck (Deerfield, IL)
- …model development, deployment, and optimization for marketing, sales and/or commercial initiatives. + Strong Proficiency in predictive modeling and machine-learning ... In-depth experience working with pharmaceutical datasets (first-party patient data, third-party claims , EHR, demand data). + Excellent oral and written communication… more
- Humana (Topeka, KS)
- …The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems of ... + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about contributing to an organization focused… more
- Grundfos (Katy, TX)
- …and drive performance. + Assist with quotations, order processing, warranty claims , and related reporting. + Develop advanced documentation for nonstandard product ... Strong written and verbal communication skills. + Ability to travel via normal commercial modes both within the US and internationally as required. Please note that… more
- UHS (Johnson City, NY)
- …to identify causes, update records accordingly, and support efforts to reprocess claims for payment. + Maintain current knowledge of insurance payers relevant to ... outpatient services, including managed care, government programs, commercial insurers, and workers' compensation. + Serve as a resource to outpatient staff for… more
- Air National Guard Units (Kelly, NC)
- …to qualify for this position, you must provide transcripts to support your educational claims . GS-0308-09 A master's or equivalent graduate degree or 2 full years of ... duty day. 4. The employee may be required to travel in military and/or commercial aircraft to perform temporary duty assignments. 5. Individual must possess a secret… more
- Waystar (Louisville, KY)
- …+ Experience working with **healthcare data** and understanding RCM processes ( claims , billing, payments). + Familiarity with data orchestration tools (eg, ... providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers. We are deeply committed to living out our… more
- Belcan (Kent, WA)
- …components. * Foster and maintain positive supplier relationships. * Ensures commercial , legal, ethical, and contractual compliance in all procurement transactions. ... desired, preferably in a high-volume, low-mix environment * Experience negotiating claims and resolving disputes with suppliers. * Aerospace industry experience and… more
- AIG (Jersey City, NJ)
- …is at the heart of everything we do, from underwriting risks to processing claims . The Information Technology (IT) team equips our colleagues with the latest tools ... to the world American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world's most far-reaching… more
- Philadelphia Insurance Companies (San Diego County, CA)
- …member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. ... the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an… more