- Trinity Health (Westchester, IL)
- …Case Management, and Managed Care to gather necessary information and ensure claims are processed efficiently. **Key Responsibilities:** + Proactively follow up on ... claim rejections and denials, make corrections, and take appropriate actions or refer claims to the necessary team for resolution. + Evaluate accounts and resubmit … more
- Zurich NA (Columbia, SC)
- …Qualifications** * Bachelors Degree and 7 or more years of experience in the Claims , Consulting, Risk Engineering or Underwriting area OR * High School Diploma or ... Equivalent and 9 or more years of experience in the Claims , Consulting, Risk Engineering or Underwriting area OR * Zurich Certified Insurance Apprentice, including… more
- Commonwealth Care Alliance (Boston, MA)
- …satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + ... the primary liaison to the provider community, researching, resolving, and escalating complex provider issues as needed. + Own provider relationships to drive… more
- Zurich NA (Lansing, MI)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... including an Associate Degree and 8 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft Office OR AVP, Underwriting… more
- BD (Becton, Dickinson and Company) (Sandy, UT)
- …healthcare audiences and regulatory environments, along with the ability to translate complex clinical concepts into clear and effective positioning to ensure that ... personas, insights, brand positioning statements, benefit ladders, and differentiated claims , to support launches, drive adoption, and accelerate growth across… more
- Transdev (Lombard, IL)
- …staff position within North American headquarters responsible to support FP&A Manager and Director of Accounting on a variety key projects. We offer a competitive ... support for key internal topic of insurance and insured claims estimates + Work with actuary and risk department...and monthly financial reporting review package + Works on complex finance topics as needed to support internal team.… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …Senior Manager of Process, Policy & Governance reporting to the Senior Director , Procurement Operations; your primary focus will be the maintenance and enhancement ... skills, ability to speak to the business and simplify complex technical aspects into concepts business partners can understand,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Fluor (Greenville, SC)
- …management and execution of the Prime Contract in conjunction with the Project Director and Law Department. Complexity of projects and the associated risk will be ... less than typically managed by a Director I. Ensure compliance with government regulations, statutes, and...(EPC) contracting covering the entire life cycle of large complex projects. + The position will ensure compliance with… more
- Genesis Healthcare (PA)
- …will be key in assisting with the LTC ACO HCC program ensuring that claims are coded and documented accurately and completely, helping to identify remediation needs ... and vision of the organization by working with the Director of Quality Coding and Provider Compliance in identifying...and Ethics Program, Standard code of Conduct, Federal False Claims Act and HIPAA. 2. Assist in the maintenance… more
- Omaha Children's Hospital (Omaha, NE)
- …Brief Overview** The Sr. Managed Care Contract and Revenue Analyst will conduct complex and detailed analysis and modeling of managed care contracts for the ... Revenue Cycle leadership. **Essential Functions** + Provides analytical support to the Director of Managed Care * Review and project contract performance based on… more