- Stanford Health Care (Palo Alto, CA)
- …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist ... timely and accurate resolution of appeals, ultimately contributing to the financial health of the organization. There are three (3) career banded levels within… more
- Commonwealth Care Alliance (Boston, MA)
- …Alliance's (CCA) diverse provider community - including physician, hospital, behavioral health , community-based, LTSS, and HCBS providers. This individual serves as ... relationships with providers across all specialties -, physician, hospital, behavioral health , community based, and ancillary providers and their staff. + Serve… more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... as well as a focus on collaborative business relationships, value based care, population health , or disease or care management. **Use your skills to make an impact**… more
- Centene Corporation (Sacramento, CA)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- CareFirst (Baltimore, MD)
- …technology support, Utilization Management (UM) operations, Clinical Product Configuration, Health Plan Claims /Authorization workflows, or related healthcare ... projects as needed. Maintain a strong working knowledge of the FACETS claims -to-authorization matching workflow and utilize this knowledge to identify and resolve… more
- Adecco US, Inc. (Stanford, CA)
- **Contract Inpatient Coding Specialist - Remote | $28-$41/hr | 6-Month Contract | 6:00am-2:30pm** **Required Certifications (One of the Following):** + **RHIA - ... Registered Health Information Administrator** + **RHIT - Registered ...accurate, detail-driven coding professional who thrives in a fully remote environment? Do you love diving into documentation, ensuring… more
- Centene Corporation (Jefferson City, MO)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- The Hershey Company (IN)
- …and off-site medical providers, including, but not limited to, physical therapists, specialists , and/or Nurse Case Managers. * / Claims Management/* * Timely ... *Whitestown, Indiana - Onsite, 5 days per week (No Remote ) * Job Summary:* Reporting to the EHS manager,...Job Summary:* Reporting to the EHS manager, the Occupational Health Nurse will provide professional and comprehensive health… more
- University of Rochester (Albany, NY)
- …to all and is a place where all can thrive. **Job Location (Full Address):** Remote Work - New York, Albany, New York, United States of America, 12224 **Opening:** ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- Health Care Service Corporation (Tulsa, OK)
- …Inquiries Involving Member*S Requests For Appeals. May Train And Mentor Less Experienced Appeals Specialists . THIS IS NOT A FULLY REMOTE POSITION. THIS IS A ... or GED. * 3 years' experience in a customer service role OR in a health insurance or medical environment. * Knowledge of medical terminology to include coding. *… more
