• Remote Medical Director - South Carolina

    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
    Centene Corporation (05/24/25)
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  • Customer Service Representative - Refill Pharmacy…

    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
    The Cigna Group (05/28/25)
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  • AR Revenue Cycle Specialist III

    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
    Johns Hopkins University (05/20/25)
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  • Clm Resltion Rep III, Hosp/Prv

    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
    University of Rochester (05/13/25)
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  • Revenue Cycle Integrity Analyst, Full-Time…

    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
    Virtua Health (05/19/25)
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  • Inpatient Coding Quality Officer III - (Medicare)

    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
    RWJBarnabas Health (03/21/25)
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  • Coding Auditor - Inpatient

    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
    BayCare Health System (03/22/25)
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  • Outpatient Clinical Documentation Integrity (CDI)…

    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
    Fairview Health Services (05/25/25)
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  • Consultant, Nurse Disability

    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
    Lincoln Financial (05/22/25)
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  • Pharmaceutical Sales Representative

    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
    Otsuka America Pharmaceutical Inc. (05/21/25)
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