- Axis (Alpharetta, GA)
- …available upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims...practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the implementation of Management… more
- Grant Thornton (Atlanta, GA)
- As a Healthcare Process Risk Senior Associate, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand their ... exceptional expertise and experience in healthcare providers, specifically hospitals, academic medical centers, and healthcare systems. This includes areas such as… more
- CVS Health (Harrisburg, PA)
- …a Regional Pharmacy Onsite Auditor, you will be an essential part to the Pharmacy Audit Department at CVS/Caremark. In this role, you will be based from your home ... and travel onsite to conduct claims audits at pharmacies throughout multiple states by reviewing...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CHS (Clearwater, FL)
- … claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
- NTT DATA North America (Ontario, CA)
- NTT DATA is currently seeking ** Senior Medical Claims Examiners (3+ years of Xcelys required)** to join our US based team. This is a 100% remote role. **Must ... as a senior -level adjudicator and SME for medical claims within the Xcelys environment. Provide... processed per day / throughput + Accuracy / audit scores + Rework / error rate + Turnaround… more
- American Water (Camden, NJ)
- …package including 401(k),Defined Contribution Plan, Employee Stock Purchase Plan, medical , prescription, dental and vision coverage, plus disability, paid time ... wastewater services to our communities. Effective, efficient, and intelligent insurance claims management, oversight, and forecasting are essential to this mission.… more
- NTT DATA North America (Ontario, CA)
- …**Job Description** To serve as a senior -level adjudicator and SME for medical claims within the Xcelys environment. Provide subject-matter expertise on ... ** Senior Claims Examiner (Xcelys System)** **NTT...**Key Duties & Responsibilities** -Adjudication & Review -Process comprehensive medical claims using Xcelys and associated subsystems… more
- Cardinal Health (San Juan, PR)
- …with other documentation and coding and billing standards; communication of audit results to physicians, physician leadership, senior leadership, management, ... medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles… more
- Ascension Health (Austin, TX)
- …requirements established by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to ... that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes....of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision… more
- AutoZone, Inc. (Memphis, TN)
- …due AutoZone. **Responsibilities** ** Senior Focus - Data Responsibilities or 3rd Party Audit Support:** DATA + Assist the Senior Manager with the Annual ... **Job Description** As a **Sr. Audit Recovery Auditor** , you will Utilize analytical...3rd Party vendors to recover less than 10% behind Senior Auditor. Negotiate and communicate flawlessly with Merchandising and… more
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