- Hospice of the Valley (Phoenix, AZ)
- …Paid Time Off. + Flexible schedules for work/life balance. **Position Profile** The Claims Review Coordinator is responsible for managing and coordinating ... matter expert related to the adjudication of all external medical claims . Able to implement and streamline processes utilizing technology. **Responsibilities**… more
- CVS Health (Phoenix, AZ)
- …The ideal candidate will be able to work independently and with others to review claims tied to different overpayment projects in the Overpayment Tracking ... This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review...Follow validation instructions provided by our constituents to properly review ACAS claims for overpayment * Utilize… more
- Highmark Health (Phoenix, AZ)
- …+ Identify and report improper coordination of benefit billing practices through paid claims review . + Complete other assigned duties as specified. + ... and efficient delivery of pharmacy call center services. The Pharmacy Coordinator is responsible for supporting Highmark Wholecare's pharmacy programs with a… more
- Centene Corporation (Phoenix, AZ)
- …100% remote.** **Position Purpose:** Analyze and resolve verbal and written claims and authorization grievance/appeals from providers and members. Resolve all State ... inquires related to complaints, grievances and appeals. + Review and process member and provider grievances and appeals...in related field or equivalent experience. 2+ years of claims , contracting, or related experience in a managed care… more
- Prime Therapeutics (Phoenix, AZ)
- …results with limited supervision. + Demonstrated strategic and analytical abilities to review and evaluate information such as claims data, suspicious patterns ... DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist) in the performance of...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more