- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …certification, School/Residency/Fellowship completion, Hospital privileges verification, System Award Management (SAM), Claims history, Accreditation (ancillary ... OIG reports, SAM report, Board certification, Hospital privileges verification, claims history, Accreditation (ancillary facilities), and obtaining additional information… more
- BrightSpring Health Services (Beaumont, TX)
- …personnel costs, consultant services, etc + Monitors worker's compensation and unemployment claims for assigned service site(s) + Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas...area regulations. Exceptions must have written approval from Regional Management . + A minimum of two years of verifiable… more
- Walmart (Bentonville, AR)
- …business growth. The Senior Manager - Actuary, reports directly to the Finance Director of Risk & Benefits with a mission to provide recommendations and support ... space. This is a heavily matrixed environment with daily interactions with Claims , Legal, Finance, and Controllership functions. **What you'll do** : + Analyze… more
- Tidelands Health (Murrells Inlet, SC)
- …reaching out to denials team members for review of denials and/or rebilling of claims related to revision of order for services. + **Work in conjunction with various ... the patient payment portal. + **Report any repetitive issues to Assistant Director of PFS.** Remaining in communication with manager regarding high-risk accounts and… more
- BrightSpring Health Services (San Angelo, TX)
- …personnel costs, consultant services, etc + Monitors worker's compensation and unemployment claims for assigned service site(s) + Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas...area regulations. Exceptions must have written approval from Regional Management . + A minimum of two years of verifiable… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Under supervision of Manager and / or Director , support the managed care contracting function by performing necessary financial analysis to evaluate ... averages, comparing to Government fee schedules and analyzing existing healthcare ( claims ) data and reimbursement terms and payment methodologies; with the goal… more
- Sarasota County Government (Sarasota, FL)
- …North County Program Director and provide coverage for judges during small claims pre-trials, along with other duties as assigned. About the Schedule Work Hours: ... with parties to encourage voluntary participation in mediation. + Facilitate small claims court proceedings and assign volunteers to mediate cases. + Schedule,… more
- InGenesis (Columbia, SC)
- …criteria and assess and monitor medical necessity using your clinical proficiency and claims knowledge. This is a REMOTE opportunity for candidates living in the ... determinations. * Identify and makes referrals to appropriate staff (Medical Director , Case Manager, Preventive Services, Subrogation, Quality of care Referrals,… more
- Latham, The Pool Company (Latham, NY)
- …communicates with homeowners and dealers regarding warranty/ non warranty items ( claims , repairs, inquiries, etc.). This manager will handle escalations from ... employee development, and other projects as assigned by the Director of Warranty. Some of What You Will Do:...of What You Will Do: + Reviews warranty inquiries/ claims and classifies warranty or non-warranty. + Handles Dealer/… more
- UIC Government Services and the Bowhead Family of Companies (Huntsville, AL)
- …from capture planning through submission + Write and edit technical and management volumes for Army and DoD proposals, including EXPRESS and GSA responses ... and discriminators tailored to each opportunity + Work with the Regional Director to ensure alignment between pipeline, partnerships, and execution strategy + Other… more