- Magellan Health Services (Albuquerque, NM)
- … Claims Internal Resolution Analyst is responsible for coordinating the resolution of claims issues locally at the health plan by actively researching and ... across multiple operational areas. + Investigates and facilitates the resolution of claims issues, including incorrectly paid claims , by working with multiple… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …healthcare payer domain in Multi-employer Trust (Hours & Eligibility management), Health Plan Administration (Benefits & Claims Administration, Vendor ... Business Analyst in the healthcare payer domain with Multi-employer Trust or Health Plan administration of self-funded client who excels in client interactions, and… more
- Elevance Health (Richmond, VA)
- **Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... ideal candidate will live within a commutable distance from our PulsePoint locations. CareBridge Health is a proud member of the Elevance Health family of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Healthcare Claims Examiner skilled in the interpretation of Hospital and Ancillary ... Payment procedures as well as capable of manually processing claims according to all outlined Policies and Procedures. This...business school education is a plus. About At Brighton Health Plan Solutions, LLC, our people are committed to… more
- Atlantic Health System (Morristown, NJ)
- + Responsible for overseeing the claims function, ensuring the timely and proper disposition of all claims made against corporation, licensed professionals and ... claim through the resolution of the claim. Principal Accountabilities: Reviews new claims with in-house counsel regarding liability and management plan. + Engages in… more
- MVP Health Care (Schenectady, NY)
- At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, ... we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity...well-being + An opportunity to shape the future of health care by joining a team recognized as a… more
- Robert Half Accountemps (Richmond, VA)
- …home health billing processes. Responsibilities: * Manage Medicaid and home health billing, including claims for Aetna, Anthem, Sentara, United, and other ... to contribute to healthcare operations by ensuring accurate billing, resolving claims , and supporting patient scheduling. Based in Richmond, Virginia, this role… more
- Humana (Carson City, NV)
- …first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on ... Qualifications** + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Humana (Little Rock, AR)
- … first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on ... Qualifications** + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Robert Half Legal (Washington, DC)
- …* Request and manage medical records, bills, and liens from providers. * File health insurance claims with medical providers and ensure accuracy. * Verify ... Compile and prepare comprehensive demand packages for legal cases. * Assist with claims processing and documentation for various cases. * Open and organize new case… more