• Executive Director, Clinical Health Services…

    CVS Health (Hartford, CT)
    …affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local ... and OCPO for Health Affordability and SAI to review medical cost trends and working across lines of business...+ Experience with and knowledge of CPT and HCPCS coding guidelines and principles. + Understanding of clinical guidelines,… more
    CVS Health (09/24/25)
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  • Senior SIU Investigator

    Centene Corporation (Frankfort, KY)
    …claim analysis, or fraud investigation experience. Knowledge of Microsoft Applications medical coding , claims processing, and data mining preferred. ... in Business, Criminal Justice, Healthcare, related field or equivalent experience. 3+ years of medical claim investigation, medical claim audit, medical more
    Centene Corporation (09/24/25)
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  • Associate Operations Director, Clinic/Center…

    CenterWell (Daytona Beach, FL)
    …+ Monitor and manage data analytics, scorecards, cost & utilizations, HCC coding , and NPS Scores, focusing on patient satisfaction and performance improvement. + ... to Market President. **Dyad Partnership** : + Collaborate with the Associate Medical Director to achieve shared goals, ensuring consistent communication and unified… more
    CenterWell (09/23/25)
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  • Prior Authorization Coordinator

    Fallon Health (Worcester, MA)
    …School Diploma; College degree (BS or BA) or equivalent preferred **License/Certifications:** Medical Terminology or Medical Coding helpful **Experience:** + ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for… more
    Fallon Health (09/22/25)
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  • Physician Practice Manager

    AdventHealth (Port Charlotte, FL)
    …RD, Wesley Chapel, 33544 **The community you'll be caring for** **:** AdventHealth Medical Group West Florida Rollover PDO with service year increases in accrua ... Practice Manager is responsible for the day-to-day operational success of the assigned medical practice(s). A Practice Manager has a one or two practice locations… more
    AdventHealth (09/19/25)
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  • Care Coordinator Tier II

    ChenMed (Decatur, GA)
    …other related duties as assigned. **KNOWLEDGE, SKILLS AND ABILITIES:** + Knowledge of medical terminology, CPT, HCPCS and ICD coding preferred + An inept ... this role works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical more
    ChenMed (09/19/25)
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  • Billing Coordinator - Accounts Receivable-MSH

    Mount Sinai Health System (New York, NY)
    …2 years healthcare billing experience required. Familiarity with CPT and ICD ( coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. ... to supervisor. 4. Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations. 5. May...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
    Mount Sinai Health System (09/17/25)
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  • Workers Compensation Claims Associate

    Sedgwick (Pascagoula, MS)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Associate **PRIMARY PURPOSE** : To analyze reported ... and industry best practices. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Adjusts medical -only claims and minor lost-time workers compensation claims under close… more
    Sedgwick (09/17/25)
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  • Pulmonary/Critical Care Physician - HealthAlliance…

    WMCHealth (Kingston, NY)
    …link Job Details: Job Summary: HealthAlliance Hospital, part of the Westchester Medical Center Health Network (WMCHealth), is seeking a Board Certified / Board ... hospitalized patients on an as-needed basis. + Work closely with the hospital's medical staff to ensure coordinated, high-quality patient care. + ICU Coverage +… more
    WMCHealth (09/12/25)
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  • Clinical Care Coordinator-Unit - FT - Day

    Nuvance Health (Danbury, CT)
    …emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate status is assigned. Assures patient ... level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure accurate and complete documentation of the… more
    Nuvance Health (09/12/25)
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