- Elevance Health (Houston, TX)
- …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you ... + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Roanoke, VA)
- …by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... with ICD-9/10CM, MS-DRG and APR-DRG. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing… more
- Elevance Health (Indianapolis, IN)
- …The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. The **Provider Contract Cost of Care Consult Senior / VBC** is ... will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing...to management. + Uses analytic tools to: track both health risks and compliance, as well as supporting the… more
- McLaren Health Care (Indianapolis, IN)
- …Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ ... Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of...TPA, PHO and Managed Care functions including understanding of claims administration, including CPT-4 codes, revenue codes, HCPCS codes,… more
- Stanford Health Care (Palo Alto, CA)
- …A/R, cash-management requirements, managed care contractual terms and requirements, health insurance practices, industry regulatory requirements (compliance and ... Hour (United States of America) **This is a Stanford Health Care job.** Are you a seasoned revenue cycle...health plans and medical groups to support effective claims submission/resolution and contract compliance. Maintains a climate of… more
- Baylor Scott & White Health (Dallas, TX)
- …of experience in healthcare leadership - Must have network experience with both a health insurance plan (payer) and a health system (provider). Strongly ... **About Us** Here at Baylor Scott & White Health we promote the well-being of all individuals,...consistency between contract terms and adjudication of authorizations and claims . - Plays a critical role in overseeing pricing… more
- CommonSpirit Health (Steubenville, OH)
- …days off), Professional Dues, and Certification Reimbursement + Malpractice and Tail Insurance (Modified Claims Made) + Full Benefits Eligibility with ... Summary and Responsibilities** Join a dynamic team with Trinity Health System and make a difference in a thriving...and make a difference in a thriving community! **Trinity Health System** , a part of the CommonSpirit Family,… more
- CommonSpirit Health (Steubenville, OH)
- …Dues, and Certification Reimbursement(with Full Time Status) + Malpractice and Tail Insurance (Modified Claims Made) + Full Benefits Eligibility with ... Summary and Responsibilities** Join a dynamic team with Trinity Health System and make a difference in a thriving...and make a difference in a thriving community! **Trinity Health System** , a part of the CommonSpirit Family,… more
- Anthony Jordan Health Corp (Rochester, NY)
- …* Corporate Compliance Apply Job Type Full-time Description The health services that became theAnthony L Jordan Health ... 1904. As one of the first 5 Federally Qualified Health Centers (FQHC) established in the nation, its roots...identification and incident management . Proactive risk reduction and claims prevention . To manage and encourage ongoing education… more
- Mount Sinai Health System (New York, NY)
- …for the day to day risk management activities for The Mount Sinai Health System, including investigating, managing and analyzing risk management data; complying with ... Commission, other accrediting agencies, and the New York State Department of Health and conducting risk management educational programs. The Clinical Risk Manager is… more