- Centene Corporation (Columbia, SC)
- …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 Cigna Group (Newburyport, MA)
- …insurance, and payment information. + _Be a team player_ - Escalate complex claims to the Sr. Billing & Reimbursement Specialists for appropriate action. ... service provider with speeds of at least 10Mbps download/5Mbps upload. **About Evernorth Health Services** Evernorth Health Services, a division of The Cigna… more
- Johns Hopkins University (Baltimore, MD)
- …III_** who will be responsible for the collection of unpaid third-party claims and independent resolution of complex appeals, using various JHM applications and ... Communicates with payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy denials and… 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
- Virtua Health (Mount Laurel, NJ)
- At Virtua Health , we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to ... care you need. Whether that's wellness and prevention, experienced specialists , life-changing care, or something in-between - we are...or something in-between - we are your partner in health devoted to building a healthier community. If you… more
- RWJBarnabas Health (Oceanport, NJ)
- …III - (Medicare)Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding Quality Location: ... and/or RN also encouraged. Scheduling Requirements: + Position is primarily remote with occasional onsite requirement. Essential Functions: + Ensures the accuracy… more
- BayCare Health System (NC)
- …largest employers within the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the State of Florida, Georgia, South Carolina, or ... + **Days:** Monday - Friday The **Inpatient** **Coding Auditor** is a full-time remote position. This team member must currently reside in Florida, Georgia, or North… more
- Fairview Health Services (St. Paul, MN)
- …accuracy in support of building a model of care focused on quality and health outcomes. You will work closely with our Population Health , Clinical, and ... and compliance of clinical documentation. Outpatient CDI performs clinically based health record reviews to facilitate and obtain appropriate provider documentation… more
- Lincoln Financial (Washington, DC)
- …NC (North Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee **Relocation assistance:** is not available for ... be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a clinical resource for… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …support to bridge care gaps. In Otsuka's evolved customer engagement model, a Health Science Advisor (HSA) will engage HCPs through a variety of in-person, virtual ... products and the approved conditions they treat. Otsuka's Clinical and Scientific Specialists (CSS) will provide deep clinical expertise on-demand and will engage… more
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