- Corewell Health (Grand Rapids, MI)
- …reported. These efforts will support the organization's cost containment efforts specific to medical claims payment and drive payment integrity performance. ... to Provider appeals. + Knowledge and understanding of plan products, payment methodologies, medical and payment policies. + Reviews and provides feedback… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …opportunities across claims systems. Your work will ensure compliance with BCBSMA Medical and Payment Policies, industry standards, and audit protocols while ... healthcare? Bring your true colors to blue. What We Need The Payment Integrity Audit Consultant role is responsible for high-impact initiatives that enhance… more
- LA Care Health Plan (Los Angeles, CA)
- …medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management ... Registered Nurse - Payment Integrity Nurse Coder RN III Job Category:...position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well… more
- Elevance Health (Gilbert, MN)
- …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment . Researches new healthcare-related questions as ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days… more
- Elevance Health (Pittsburg, KS)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The Carelon Payment Integrity Manager is responsible ... **Carelon Payment Integrity Manager** **Sign-on Bonus:** **$3,000** _Hybrid 1:...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- Select Medical (Mechanicsburg, PA)
- …+ Ensure proper approvals are obtained for RFP's in accordance with Select Medical payment hierarchies. + Sustain focus andattention to detail/accuracy, perform ... **Overview** **Accounts Payable Representative I - Invoice Processing** **Select Medical Corporate Headquarters** 4714 Gettysburg Road Mechanicsburg, PA 17055 **Full… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the total value of our trend management initiatives in the areas of medical policy, payment policy, care management, pharmacy, health and wellness programs, ... to support new trend management initiatives in the areas of medical policy, payment policy, care management, pharmacy, behavior change, health and wellness… more
- Colorado State University (Fort Collins, CO)
- …up with insurance to discuss why a "take-back" occurred and provide information to Medical Billing & Payment Posting Specialist who works denials to correct ... on the students medical insurance plan. + Work with the Medical Billing & Payment Posting Specialist to determine best next step for contesting denials. +… more
- Select Medical (Mechanicsburg, PA)
- …+ Ensure proper approvals are obtained for RFP's in accordance with Select Medical payment hierarchies. + Sustain focus andattention to detail/accuracy, perform ... **Overview** **Select Medical Corporate Headquarters** 4714 Gettysburg Road Mechanicsburg, PA...to learn what it's like to work at Select Medical . We would love you to join our team!**… more
- WMCHealth (Valhalla, NY)
- …for interviewing patients and/or their relatives to evaluate a patient's coverage for payment of their medical treatment and to determine the method of ... payment /reimbursement to Westchester Medical Center. This involves coordination with other ...of Work: (Illustrative Only) Interviews patients to determine their medical coverage, methods of payment , and to… more
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