- CVS Health (Hartford, CT)
- …- Advanced skills with Microsoft Excel - Experience in healthcare/medical insurance claims investigation or professional/clinical experience - Background with ... At CVS Health , we're building a world of health...prevent payment of fraudulent, abusive, or otherwise improperly billed claims submitted by providers, members, and others - Facilitates… more
- Elevance Health (Indianapolis, IN)
- …information as needed. + Copies incoming and outgoing correspondence. + Ensures rejected claims were denied correctly or determines if those claims should be ... matched to a member. + Manually matches or denies claims that are halted in our system because of...Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- Elevance Health (Louisville, KY)
- …of direction, training and guidance for less experienced staff. + Analyzes pertinent claims , medical records. + Strong us of analytical skills with the ability to ... for improvements. + Capability to apply industry coding guidelines to claims processes. + Demonstrated experience in reviewing, analyzing, and researching coding… more
- Elevance Health (Mason, OH)
- …with fraud and abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...Bachelors degree strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (Norfolk, VA)
- …medical policy, reimbursement and provider utilization patterns. + Coordinates prompt claims resolution through direct contact with providers, claims , pricing ... Capabilities, and Experiences:** + Provider facing experience strongly preferred. + Claims experience strongly preferred. + Maryland Medicaid experience preferred. +… more
- Elevance Health (Norfolk, VA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...dealing with Healthcare Fraud Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (Waukesha, WI)
- …make an Impact:** + Reviews and evaluates accident or incident reports, individual claims , medical, legal or other documents relating to subrogation. + Responds to ... files, correspondence, legal documents and other information related to subrogation claims . + Coordinates actions involving accounting for payments received. +… more
- Baystate Health (Springfield, MA)
- **Summary:** Responsible for wide array of legal functions of large health care system including, but not limited to, advising administration and senior management, ... of corporate law, business transactions, financing, medical staff, regulatory compliance, health law, legal aspects of drug diversion detection, mitigation, and… more
- Elevance Health (Mason, OH)
- …are pioneering the use of weekly trend data, predictive analytics, and multi-source health indicators to anticipate future health cost drivers and enable faster, ... Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and...and predictive models using large, complex datasets to forecast health claim activity and utilization patterns. + Translate complex… more
- Elevance Health (Indianapolis, IN)
- A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, ... but are not limited to: + Researches and interprets claims issues while ensuring good, accurate and timely customer...Experience with Excel preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more