- CVS Health (Cumberland, RI)
- …enrollment across locations, reporting discrepancies and recommending corrective actions. Reviews claims on trends, errors, enrollment status, insurance package ... Lead Coordinator is responsible for ensuring the timely and accurate processing of payer enrollment applications, including initial submissions and revalidations for… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …systems as assigned. Will use Epic, FISS, Connex, Nehen, and FinThrive for processing and follow-up activity for Inpatient/Outpatient claims as assigned. + Keeps ... and Gift of Life accounts to ensure accurate reimbursement and final adjudication of claims as needed. Works prebilling edits in the billing and scrubber systems to… more
- NTT DATA North America (Raleigh, NC)
- …on analytics and reporting related to core payer data, including member eligibility, claims processing , and membership. Extract, analyze, and validate data to ... will depend on the nature of the role offered. Company benefits may include medical , dental, and vision insurance , flexible spending or health savings account,… more
- Alabama Oncology (Birmingham, AL)
- …or a high school graduate + 3 plus years of experience + Experience in medical billing / insurance processing and balancing accounts Company Benefits + ... for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action,...of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and… more
- Elevance Health (San Juan, PR)
- …within the enterprise. Included are processes related to enrollment and billing and claims processing , as well as customer service written and verbal inquiries. ... management. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries,… more
- Humana (Oklahoma City, OK)
- …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Assist in developing FWA education to ... (Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development + Experience in a… more
- Sedgwick (Jacksonville, FL)
- …to meet those needs. + Develop and modify software based on data processing requests. + Ensure compliance with insurance carrier and regulatory requirements ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance VB.Net Middleware Developer Join us in delivering cutting-edge technology solutions… more
- Otsuka America Pharmaceutical Inc. (Montpelier, VT)
- The Manager, Contracts (Non-HCP SOWs) is an important role within the Medical Excellence & Operations team within Global Medical Affairs. This role is ... responsible for end-to-end management of contracts that support Global Medical Affairs operations, excluding those with healthcare professionals or organizations.… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Scientific Communications manages the execution of the core scientific and medical communications strategy for the relevant therapeutic area portfolio. This role ... plan. This position provides guidance, coaching, and oversight to the Manager, Medical Core Content, ensuring all materials are developed with scientific accuracy,… more
- Otsuka America Pharmaceutical Inc. (Little Rock, AR)
- …strategy, operational oversight, and performance management of the Rare Disease Field Medical Affairs (FMA) team. This role manages the unique challenge of ... strategy reflects patient perspectives. The Director is responsible for medical customer engagement, including the hiring, development, coaching, and strategic… more