- CVS Health (Bloomington, MN)
- …configuration data, clinical protocols, and medical notification documents within CVS Health 's Medical Claims and Prior Authorization platform (Novologix). The ... At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming … more
- J&J Family of Companies (Titusville, NJ)
- …to perform scientifically rigorous RWE studies via analysis of secondary data such as claims databases and electronic health records. This person will design and ... learning, evaluating, and validating models, based on information available in administrative claims , electronic health records, and other data sources. This… more
- HCA Healthcare (Austin, TX)
- …relational database design, programming language(s), SAS, data transfer methods, and electronic health record and health care claims standards and/or ... + Experience with large health care data sets including, electronic health records, Medicare claims , or other health care claims data sets preferred.… more
- R1 RCM (Salt Lake City, UT)
- …in the health insurance industry (Commercial Insurances, Medicare, Medicaid); health claims billing and/or Third-Party contracts, minimum of two years ... relevant questions and obtain appropriate information in pursuit of resolving unpaid claims . Appeals Specialist incumbents must be assessed as being resourceful and… more
- Amazon (Newark, NJ)
- …analyze risks associated with copyright and trademark infringement, right of publicity and defamation claims , health and safety claims , or other potential ... risks associated with copyright and trademark infringement, right of publicity and defamation claims , health and safety claims , or other potential claims … more
- CVS Health (Franklin, TN)
- …support + Familiarity with Final Expense, A&H, Medicare Supplement policy processing, or health insurance claims . + Experience working in a production or ... At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming … more
- Highmark Health (Buffalo, NY)
- …3 years of Working knowledge of medical procedures and terminology + 3 years of Health Care claims , Health Insurance and Benefit Administration **SKILLS** ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
- Amentum (Albany, NY)
- …algorithms to detect anomalous billing trends and patterns. + Extract and manipulate federal health claims data using CMS tools such as OnePI, STARS, Business ... entities, and assets. + Analyze large and complex healthcare claims datasets to identify fraud, waste, and abuse patterns....matter area involved - for example, Medicare billing and claims systems, or DoD inventory systems. + Working knowledge… more
- MetLife (New York, NY)
- …use of OCR, NLP and LLMs, and building a brand-new ontology for animal health claims . * Governance and data expertise: Establish governance frameworks for data ... roadmap for Pet, aligned with business objectives and enterprise data strategy. * Claims automation: Given the exponential growth of the Pet business, claims … more
- Independent Health (Buffalo, NY)
- …benefit managers, and other insurance companies to accurately identify Independent Health responsibility for primary claims payment. Technical Proficiency and ... Innovation + Retain technical knowledge of Independent Health 's customer documentation and claims processing systems to review and maintain member records, as… more