- CVS Health (Scottsdale, AZ)
- …+ Coordinating the correction of Medicare Part-D claims and PDEs These audit programs help keep CVS Health plans in compliance with CMS requirements ... At CVS Health , we're building a world of health...and every day. **Position Summary** As the Medicare Pharmacy Audit Programs Project Manager you will be responsible for… more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing...results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits**… more
- Conduent (Warren, MI)
- …and be part of a culture where individuality is noticed and valued every day. ** Claims Auditor** **Position is onsite in Warren, MI** Training: Mon- Thur ( On the ... North America Supplier Claim Activity ("SCA") group is responsible for receipt, audit , processing, accrual and forecasting of supplier obsolescence and cancellation … more
- University of Utah (Salt Lake City, UT)
- …current knowledge, and interprets state and federal regulations regarding payments in health care to audit claims correctly. **Minimum Qualifications** ... **Work Schedule Summary** Hybrid weekday schedule. **VP Area** U of U Health - Academics **Department** 01663 - COMPLIANCE SERVICES **Location** Campus **City** Salt… more
- City of New York (New York, NY)
- …CIVIL SERVICE LIST ARE ELIGIBLE TO APPLY. Division/Program Summary: The Bureau of Audit Services plays a leading role in risk-based assessments of the Department's ... Innovation's policies. Position Summary: DOHMH is seeking an Assistant Audit Manager to join the Bureau of Audit...all testing schedule (PS, OTPS, Fringe, Admin, LOS, EI claims ) and draft reports and submit for Supervisors review… more
- Henry Ford Health System (Detroit, MI)
- …and general liability, workers compensation and employers liability claims review, investigation, management and disposition, including financial mitigation ... and management of System reputation Will work under the guidance of Senior Claims Managers, Senior Claims Consultant, Director of Insurance, and Vice President,… more
- CenterLight Health System (NY)
- …a pivotal role in enhancing the efficiency and effectiveness of the claims department by evaluating and refining processes, conducting comprehensive data analysis, ... guidelines. This position requires a working knowledge of Government Programs medical claims payment system and configuration with strong focus on data review and… more
- Prime Healthcare (Ontario, CA)
- …and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of Claims data, the ... position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible...TheVice President of Health Plan Operations and Claims is responsible for the development and execution of… more
- Providence (Renton, WA)
- …and retain the best people, we must empower them.** **Providence St Joseph Health operates a self-administered claims program for General and Healthcare ... organizational metrics, and propose opportunity solutions and success replication. Propose monthly audit focus topics to claims leaders based on trending… more
- FM (Johnston, RI)
- …It is responsible for contributing to the development of the internal audit strategy; leads project teams to achieve milestones and objectives, as assigned. ... Responsible for overseeing internal audit external reporting by ensuring compliance with regulatory requirements, monitoring reporting trends and providing… more
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