- Elevance Health (Mason, OH)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines...to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in… more
- Elevance Health (Norfolk, VA)
- …+ Coordinates prompt claims resolution through direct contact with providers, claims , pricing and medical management department. + Identifies and reports on ... + Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns. + Conducts seminars to… 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, ... primary contact and liaison for and between the company's medical partners and the pharmacy vendor for implementing and...but are not limited to: + Researches and interprets claims issues while ensuring good, accurate and timely customer… more
- Mount Sinai Health System (New York, NY)
- … System:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across ... Operations to deliver data products that inform strategic decisions across the Health System. The Analyst plays a key role in developing interactive dashboards… more
- Otsuka America Pharmaceutical Inc. (Des Moines, IA)
- Otsuka Precision Health is a health experience company that brings personalized care within reach through products and services for mental and physical ... the power of human interaction with technology, we tailor solutions to support individual health needs and improve how people engage. Data is the cornerstone of our… more
- UnityPoint Health (Urbandale, IA)
- …prior authorization completion for specialty medications. Understands pharmacy benefit and medical benefit claims submission process for reimbursement of ... verify benefits and obtain authorization for specialty medications. + Processes test claims of health system's specialty pharmacy prescriptions through pharmacy… more
- Veterans Affairs, Veterans Health Administration (Lakewood, CO)
- …Lead Contact Representative aligned under the Unit Supervisor in the Civilian Health and Medical Program Veteran Administration (CHAMPVA) Eligibility Enrollment ... Programs (VFMP) Directorate, Office of Integrated Veteran Care (OIVC), Veterans Health Administration (VHA), Department of Veterans Affairs (VA). The incumbent… more
- Beth Israel Lahey Health (Burlington, MA)
- …experience **Skills, Knowledge & Abilities:** + Comprehensive working knowledge of medical /hospital billing practices, billing software, health care insurance, ... Line Directors, Managers, Finance Directors, clinical support staff, Physicians, allied health care providers, hospital colleagues, and others regarding matters that… more
- American Water (Chattanooga, TN)
- …an American Water employee, you will be offered a competitive salary and health benefits package, along with opportunities to develop, grow, and evolve your career. ... Our benefits packages focus on key areas such as health & wellness, emotional & well-being, and savings for...insurance company or independent counsel with regard to litigated claims . _ *Key Accountabilities (cont'd)*_ * Prepare or oversee… more
- City of New York (New York, NY)
- …provided to insured New Yorkers that seeks services in the article 28 Health specialty Clinics, Article 36, and other Care Management service areas provide by ... Patient Billing by working alongside a team of talented health insurance billing specialist, you will perform health...clinic teams to ensure transparency. - Track and manage medical records requests from MCO to obtain prior authorization… more