- Excellus BlueCross BlueShield (Buffalo, NY)
- …involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment . + Develops alliances with the ... we encourage you to apply! Job Description: This position assists the Chief Medical Director to direct and coordinate the medical management, quality improvement… more
- Centene Corporation (Raleigh, NC)
- …involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment . + Develops alliances with the ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Commonwealth Care Alliance (Boston, MA)
- …public health care programs and reimbursement methodologies (Medicaid and Medicare) + Medical Coding, Compliance, Payment Integrity and Analytics + Direct and ... direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective… more
- Motion Recruitment Partners (Denver, CO)
- …**What You Will Be Doing** Daily Responsibilities + Receives and adjudicates medical claims/bills for payment /denial. + Researches claims/bills for appropriate ... Medical Claims Processor / Contract / Remote Denver,...+ Analyzes and adjusts data and benefits criteria for payment . + Responds to and researches vendor and member… more
- MyFlorida (Tallahassee, FL)
- …business hours. This entry level position reviews, audits, and processes for payment medical invoices within the Division of Disability Determinations (DDD) ... of the position. Duties and Responsibilities: Reviews, audits, and processes for payment medical invoices daily utilizing the Social Security Administration… more
- NJM Insurance (Trenton, NJ)
- …patterns. + Perform pre- and post- payment audits on WC and PIP medical payment in accordance with established procedures. Accurately maintain and document ... is responsible and accountable for conducting complete and thorough reviews of medical bills and participating in targeted compliance and process audits to support… more
- State of Massachusetts (Medford, MA)
- …necessary. 3. Responsible for the maintenance of the physician/vendor file and medical panel follow-up procedures regarding documents for payment and licensure. ... a working knowledge of Chapter 32 and the disability regulations. 6. Renders payment of medical bills related to medical exams associated with the Disability… more
- Beacon Mobility (Merriam, KS)
- …DOT regulations. Benefits Available + Training $14.50 + Safety & Attendance Bonus + Medical Fixed- Payment Indemnity + Dental + Vision + Accident Plan + Critical ... and not having significant disciplinary issues. Fully Credentialed Bonus Payment : The sign-on bonus will be paid in three...paid out after 270 days on route. Non-CDL Bonus Payment (Candidates need to complete training and be fully… more
- Beacon Mobility (Oak Grove, MO)
- …DOT regulations. Benefits Available: + Training $15.45 + Safety & attendance bonus + Medical Fixed- Payment Indemnity + Dental + Vision + Accident Plan + Critical ... and not having significant disciplinary issues. Fully Credentialed Bonus Payment : The sign-on bonus will be paid in three...paid out after 270 days on route. Non-CDL Bonus Payment : The sign-on bonus will be paid in three… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …deployment. This work includes a variety of modeling and analytics to support medical economics, payment integrity, and various other areas of finance. ... care delivery system and health plan operations, including knowledge of Medical Economics, Trend Management, Pricing, Forecasting, Provider Payment … more