- Elevance Health (Wilmington, DE)
- ** Provider Reimbursement Manager ** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... considered for employment, unless an accommodation is granted as required by law. The ** Provider Reimbursement Manager ** manages key components of the … more
- Sanofi Group (Wilmington, DE)
- **Job Title:** Field Reimbursement Manager , Dermatology - South Jersey **Location:** Remote/Field **About the Job** The Field Reimbursement Manager (FRM) ... field subject matter expert relating to patient support, access, reimbursement , prior authorization, appeal, financial assistance, and other business-related issues… more
- Humana (Dover, DE)
- …VLOOKUP) **Preferred Qualifications** + Experience researching and resolving provider reimbursement inquiries + Experience with Optum Rate Manager + ... Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing… more
- Datavant (Dover, DE)
- …educational and life experiences to realize our bold vision for healthcare. The Provider Practice Coding Consultant role is an opportunity to make a significant ... impact in the field of medical coding. You will provide essential consulting services and educational support, guiding healthcare professionals on improved coding… more
- Elevance Health (Wilmington, DE)
- **Audit & Reimbursement Senior** **_Virtual:_** _This role enables associates to work virtually full-time, with the exception of required in-person training ... and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the… more
- Elevance Health (Wilmington, DE)
- **Audit & Reimbursement II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and Medicaid Services to transform federal health programs. The **Audit and Reimbursement II** will support our Medicare Administrative Contract (MAC) with the… more
- CVS Health (Dover, DE)
- …Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level reviews and ... expansion and strategic targets. * Collaborate cross-functionally to manage provider compensation and pricing development activities, submission of contractual… more
- Elevance Health (Wilmington, DE)
- …and APR-DRG. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria ... ** Manager DRG Coding Validation ( Manager Program...and payer-specific requirements. + Collaborates cross-functionally with clinical, compliance, provider engagement, and data analytics teams to align audit… more
- UMB Bank (Dover, DE)
- UMB's Corporate Trust and Escrow Services is a nationally recognized and ranked provider of bond trustee and agency services to the corporate and municipal ... corporate/ABS issuers of taxable or tax-exempt debt. We also provide escrow-related, custodial and verification services to corporations, not-for-profits,… more
- Humana (Dover, DE)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex… more