- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. As ... address important business questions and opportunities. You will report into the Director of Brand Analytics and support OAPI's pipeline asset(s). The Senior… more
- Covenant Health Inc. (Knoxville, TN)
- …in health care is preferred. Computer experience is required. Knowledge of medical terminology, claims submission, customer service is preferred. Expected to ... , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area's fastest-growing physician practice… more
- KBR (Houston, TX)
- …labor and employment, confidentiality agreements, payment and invoicing, risk mitigation, claims management , and dispute resolution issues and claims ... detailed commercial terms and protections, and analyze technical and commercial claims . + Successful organizational, leadership and people management skills,… more
- University of Virginia (Charlottesville, VA)
- …UVA health system locations as needed. + Works in conjunction with the medical director , administrative management , office manager and nursing staff ... to facilitate patient management through the health care system. + Exercises independent...standards as determined by the Chair of the Department, Medical Director and/or UVA Health System, UVA… more
- Baylor Scott & White Health (College Station, TX)
- …+ When adverse events harm patients, the CRM, led by the Corporate Director of Risk Management , investigates to evaluate patient harm. If organizational ... position will support two hospitals; Baylor Scott & White Medical Center - Round Rock and Baylor Scott &...Clinical Risk Manager (CRM) directs and coordinates clinical risk management for the hospital (Greater Austin Region and College… more
- Carle Health (Champaign, IL)
- …of individual patient health information for data retrieval, analysis, and claims processing. Assures revenue integrity and quality of coding through supervision ... Coding Specialist - Physician-Based (CCS-P) - American Health Information Management Association (AHIMA); Certified Coding Specialist (CCS) - American Health… more
- AmeriHealth Caritas (Philadelphia, PA)
- …appeals, the analysis of claims and appeals, and the review of medical management authorizations.; + Research and Investigate member and/or provider appeals ... making or example, internal committee/panel, independent review organization, internal medical director - as process dictates +...ensure proper handling of the appeal eg UM team, medical directors, claims , contact center, vendors as… more
- WM (Reserve, LA)
- …Since our founding over 30 years ago, we have grown from a small start-up in medical waste management into a leader across a range of increasingly complex and ... and to maintain regulatory compliance. Also responsible for local coordination and management of claims -related activities, including working closely with third… more
- University of Southern California (Newport Beach, CA)
- …scan/email ABNS to front area reception for signatures as needed. + Coordinate with Director on denied or disputed claims to obtain documentation to support ... behavior. Preferred Qualifications: + Pref Experience in area of service. + Pref Medical Prior Authorizations or Claims experience in a managed care setting.… more
- AdventHealth (Orlando, FL)
- …payers. The PA role is responsible for providing physician review of utilization, claims management , and quality assurance related to inpatient care, outpatient ... matter expert, providing clinical expertise and business direction in support of medical management programs, promoting the delivery of high quality, patient… more