- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... general supervision. PRIMARY RESPONSIBILITIES: + Conducts monthly audits of CPHL claims utilizing CPHL guidelines, policies and procedures or any other regulatory… more
- GE Aerospace (Hooksett, NH)
- …terminology and medical impairments related to long term care, disability, life and/or health insurance claims + Note: Position can be hybrid or remoteThe ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
- Corewell Health (Grand Rapids, MI)
- …analytic solutions with advanced knowledge of the primary source data (ie, electronic health records, claims ) and workflows. Leads complex project teams to ... data sources, and automation will be created from electronic health record (EHR) reporting tools and databases, (ie Clarity,...Cogito Certification within 6 months of employment About Corewell Health As a team member at Corewell Health… more
- Centene Corporation (Jefferson City, MO)
- …meets production standards and passes quality audits + Oversees relationships with health plans, claims , and other departments resulting in a significant ... and coding questions and issues + Triages and resolves escalated health plan, Claims department, and provider inquires/appeals or issues + Cross communication… more
- Hackensack Meridian Health (Hackensack, NJ)
- …+ Minimum of 2 years of experience in a healthcare billing office or health insurance claims environment. + Familiar with common medical billing practices, ... accounts receivable activity on an ongoing basis for the Hackensack Meridian Health (HMH) network. Identifies issues for management regarding significant changes in… more
- City of Lakeland (Lakeland, FL)
- …loss prevention, and wellness initiatives/clinic. Responsibilities include directly supervising Safety, Health Benefits, and Claims Team Leaders; Risk Management ... state and federal agencies dealing with insurance, safety, and health and wellness. + Monitors all claims ...and health and wellness. + Monitors all claims activity, providing a forum for discussion and adjustment… more
- Hackensack Meridian Health (Edison, NJ)
- …+ Minimum of 5 years of management work experience in healthcare receivables, health insurance claims processing, or healthcare customer service. + Extensive ... functions impacting patient financial responsibility across the Hackensack Meridian Health (HMH) network. Provides leadership to customer service functions, ensuring… more
- Jack Link's (Minneapolis, MN)
- …and Compliance + Be subject matter expert for product labeling regulations and claims requirements including nutrition, health and ingredient claims . + ... regulated product label information, including nutrition, ingredient declaration, allergens, claims and associated product communication. This position manages several… more
- AdventHealth (Maitland, FL)
- …bundled payments, pay-for-performance, and capitation Working knowledge of population health , utilization measurement, and claims analytics Managed Care, ... Patient Financial services, health insurance claims processing, contract management, or medical economics Proficiency in understanding professional and facility … more
- CenterWell (Boston, MA)
- …first** The Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more