- Merck & Co. (Rahway, NJ)
- …the individual to be an independent contributor as well as be a lead partner in helping to scope, design, and deliver well-defined advanced analytics solutions ... that are aligned to the DHH top programs - The ideal candidate will lead a cross functional insights team that spans data science, market research, data strategy,… more
- Providence (Mission Hills, CA)
- …Bachelor's Degree or equivalent educ/experience + 10 or more years of HMO claims processing and/or auditing experience in a managed care environment, preferably ... Full time **Job Shift:** Day **Career Track:** Admin Support **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills 11165… more
- Trinity Health (Troy, NY)
- …* Obtain and manage service authorizations * Prepare, review, and submit invoices and claims * Monitor and reconcile cash postings * Follow up on outstanding account ... way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce… more
- Prime Therapeutics (Washington, DC)
- …fuels our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit ... and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify...and administrative duties as required by business need. + Lead and implement positive changes with a high level… more
- CVS Health (Blue Bell, PA)
- …leading modernization efforts. + Strong understanding of regulatory compliance in claims processing . + Excellent communication and stakeholder management skills. ... do it all with heart, each and every day. **Position Summary:** The Lead Director of Software Engineering is responsible for leading engineering teams that support… more
- Humana (Providence, RI)
- …to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic, mission-driven ... help us put health first** As a Process Improvement Lead , you'll play a key role in analyzing and...+ 2+ years of demonstrated expertise in end-to-end healthcare claims operations, including claim ingestion, processing , system… more
- Centene Corporation (Harrisburg, PA)
- …as the subject matter expert for other Claims Liaisons. + Analyze trends in claims processing issues and identify work process solutions + Lead meetings ... potential configuration related work process changes + Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing… more
- Integra Partners (Troy, MI)
- …is responsible for leading complex projects and initiatives related to claims adjudication, processing , compliance, and operational improvements. This role ... requires deep subject matter expertise in healthcare claims systems, workflows, and regulatory requirements. The PM will...PM's responsibilities include but are not limited to: + Lead and manage end-to-end projects focused on healthcare DME… more
- Sedgwick (Cincinnati, OH)
- …growth, and inclusion. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Adjuster | Dedicated Client | KY,VA,WV,IN,KS,MI,MO,NE Jurisdictions | Open to… more
- Elevance Health (St. Louis, MO)
- …used for financial reporting and trending analysis. + Provides feedback on claims processing errors; identifies quality improvement opportunities and initiates ... or GED and a minimum of 5 years of claims processing experience including a minimum of...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
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- Merck & Co. (Rahway, NJ)