- Lincoln Financial Group (Providence, RI)
- …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- Humana (Providence, RI)
- … claims research/resolution *Assist with new hires training **Location: Remote US** **Shift: Monday-Friday 2:30pm-11pm EST. Flexibility to work alternating ... help us put health first** Assist local pharmacies with claims adjudication to support medication access for HC &... submissions OR be a current internal Enclara Pharmacia associate ** **Preferred Experience:** + PBM experience + Dispensing system… more
- Prime Therapeutics (Providence, RI)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Customer Care Associate I - Remote **Job Description Summary** This position is ... Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities… more
- Humana (Providence, RI)
- …to drive improvements in quality and/or reductions in total cost of care + Scorecard creation and reconciliation of provider performance based on contractual ... Qualifications:** + Bachelor's Degree + 3-5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care +… more
- CVS Health (Providence, RI)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary This...and affordable. Position Summary This role is open to remote work anywhere in the US. Must have reliable… more
- Marriott (Providence, RI)
- …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
- BrightSpring Health Services (Taunton, MA)
- …PharMerica Overview Our Point of Sale Adjudicators are crucial to our 3rd Part Claims activities and our business. This is an excellent opportunity to move from a ... pharmacy to office environment for those who are willing to learn claims , billing and insurance processing. Pharmacy Technician experience and/or knowledge of… more
- Humana (Providence, RI)
- …The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are ... of the appropriate courses of action. This is a remote position. \#LI- remote **Use your skills to...SQL Server, Netezza, Databricks) + 1+ years of Medical claims experience (auditing, processing, loading, etc ) + Experience… more
- Humana (Providence, RI)
- …Clinical Strategy and Analytics (CS&A) Team is seeking a Research Scientist 2 ( Remote ). Healthcare is rapidly changing, and our members are living longer, often with ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- Humana (Providence, RI)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more