- Evolent (Des Moines, IA)
- …and contracting. **What You'll Be Doing:** + Serve as the lead for medical cost and revenue projections for Performance Suite business + Partner with Performance ... and size impact of innovative care models + Oversee Medical Cost Action Planning work to identify, size, and...clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for… more
- Covenant Health Inc. (Knoxville, TN)
- …Shift Must be located in East TN. Position is remote and onsite. Covenant Medical Group is Covenant Health's employed and managed medical practice organization, ... to ensure compliance. + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + Performs… more
- Humana (Harrisburg, PA)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Walgreens (Rockville, MD)
- …to pharmacy errors and the Continuous Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and ... prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. + Assists and… more
- TEKsystems (Boston, MA)
- …+ Knowledge of SOAP/REST web services, XML, and JSON. + Understanding of insurance domain, particularly claims processing . + Strong problem-solving and ... for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Robert Half Finance & Accounting (Metuchen, NJ)
- …Responsibilities: * Resolve customer inquiries by troubleshooting product issues and processing warranty claims and return authorizations. * Identify ... in the United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance . Hired… more
- BayCare Health System (Clearwater, FL)
- …specifications. + Knowledge of health plan operations, benefit coverage, and claims processing . + Familiarity with regulatory requirements governing grievance ... + Conduct thorough investigations by gathering relevant information, documentation, and medical records. Triage, plan, and execute intake of Appeals and Grievance… more
- Insight Global (San Francisco, CA)
- … insurance companies.. - Support compliance functions related to medical contracts and documentation standards. Office Management: -Oversee office operations, ... Office and HRIS platforms. - Ideally working in a small healthcare/non-profit organization - Familiarity with insurance communications and claims processes. more
- TEKsystems (Columbia, SC)
- …+ Education: High School Diploma or equivalent + Experience: + 1 year of claims processing or customer service experience OR + Bachelor's Degree in lieu ... Prior inbound call center experience + Healthcare or health insurance experience + Proficiency with CRM/CSM software + Hospitality...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …order * Triages insurance rejections and initiates prior authorization claims as needed * Uses appropriate pharmaceutical- medical terms, abbreviations, and ... include a filling robot and additional space for patient care and prescription processing . /The position does include a every 3rd weekend component (Every 3rd… more