- Corewell Health (St. Joseph, MI)
- …and educate members, employer groups, providers, colleagues, and/or agents of health plan benefits with accessing services, facilitating and resolving problems, ... understanding claims , billing and coding, along with other questions. Consistently...established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well… more
- Atlantic Health System (Newton, NJ)
- …family experience, serving as an initial point of contact within our health system + Securing accurate information, + Interpreting and communicating patient ... registration + Maintains contact with third-party payers to determine reasons for outstanding claims and communicates to facilitate speedy payment of claims +… more
- Elevance Health (Hanover, MD)
- …information. **How you will make an impact:** + Synchronizes data on claims and provider databases and provides expertise on business requirements for multiple ... provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Claims support experience strongly preferred. + Maryland Medicaid or Public… more
- Dignity Health (Bakersfield, CA)
- …support across a variety of functions, including credentialing, contracting, claims , provider relations, quality/risk, care coordination, utilization management, and ... these roles will also partner closely with the Population Health Analytics function to ensure consistent and accurate reporting...in one or more of the following areas: contracting, claims management, UM or care coordination. - Bachelor's degree… more
- Elevance Health (Norfolk, VA)
- …week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations._ Carelon Payment Integrity is a proud member of the Elevance ... Health family of companies, Carelon Insights, formerly Payment Integrity,...dollar volume of provider. + Analyzes data to select claims to be reviewed, conducts reviews using medical charts,… more
- WellSpan Health (York, PA)
- …qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. Evaluates ... qualified patients, drugs, and locations. - Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. - Uses… more
- Elevance Health (Chicago, IL)
- …PI areas (Data Mining, Coordination of Benefits, Complex and Clinical Audit, Claims Edits, and the Special Investigations Unit) operating as an internal consultant ... and leadership roles, with specific knowledge in payment integrity, provider, and claims domains. + Lean Six Sigma Black Belt certification; Master Black Belt… more
- Elevance Health (Independence, OH)
- …volume of provider. + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical notes, itemized ... + Verifies dollar amount on claim is correct in claims system and writes report of the findings of...provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (FL)
- …_PLEASE NOTE: This position is not eligible for current or future visa sponsorship._ Carelon Health is a proud member of the Elevance Health family of brands, ... Senior** measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed...SAS required, and a minimum of 3 years in health care setting; or any combination of education and… more
- Henry Ford Health System (Troy, MI)
- …work remotely Under minimal supervision, is responsible for the Henry Ford Health System Insurance accounts receivable. Identifies and determines in accordance with ... of patient financial, insurance and demographic patient information to ensure compliant claims to Third party payers. Resolves problem accounts from payer denials… more