- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... as well as a focus on collaborative business relationships, value based care, population health , or disease or care management. **Use your skills to make an impact**… more
- Stanford Health Care (Palo Alto, CA)
- …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist ... timely and accurate resolution of appeals, ultimately contributing to the financial health of the organization. There are three (3) career banded levels within… more
- Centene Corporation (Sacramento, CA)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- CareFirst (Baltimore, MD)
- …technology support, Utilization Management (UM) operations, Clinical Product Configuration, Health Plan Claims /Authorization workflows, or related healthcare ... projects as needed. Maintain a strong working knowledge of the FACETS claims -to-authorization matching workflow and utilize this knowledge to identify and resolve… more
- Adecco US, Inc. (Stanford, CA)
- **Contract Inpatient Coding Specialist - Remote | $28-$41/hr | 6-Month Contract | 6:00am-2:30pm** **Required Certifications (One of the Following):** + **RHIA - ... Registered Health Information Administrator** + **RHIT - Registered ...accurate, detail-driven coding professional who thrives in a fully remote environment? Do you love diving into documentation, ensuring… more
- Centene Corporation (Jefferson City, MO)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- The Hershey Company (IN)
- …and off-site medical providers, including, but not limited to, physical therapists, specialists , and/or Nurse Case Managers. * / Claims Management/* * Timely ... *Whitestown, Indiana - Onsite, 5 days per week (No Remote ) * Job Summary:* Reporting to the EHS manager,...Job Summary:* Reporting to the EHS manager, the Occupational Health Nurse will provide professional and comprehensive health… more
- Health Care Service Corporation (Tulsa, OK)
- …Inquiries Involving Member*S Requests For Appeals. May Train And Mentor Less Experienced Appeals Specialists . THIS IS NOT A FULLY REMOTE POSITION. THIS IS A ... or GED. * 3 years' experience in a customer service role OR in a health insurance or medical environment. * Knowledge of medical terminology to include coding. *… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …and drive the ecosystem commercial strategy. + Lead a team of Neuroscience Specialists within an ecosystem to drive appropriate clinical demand and improve patient ... sources (eg, analytics) to inform regional business plans. + Coach Neuroscience Specialists to shape customer plans based on market dynamics to address customer… more
- Metropolitan Council (St. Paul, MN)
- …(audit accounts) you will be responsible to audit and process bills and claims ; post transactions; balance and reconcile accounts in order to issue and receive ... of problems and provide training, as needed. The salary range for an Account Specialists $28.30 - $45.96 per hour with an annualized range of $58,864.00 -… more