- Apex Health Solutions (Houston, TX)
- S ummary: Position is responsible for overall strategy and effectiveness of Claims Operations. Position is responsible for oversight of claims adjudication and ... also responsible for the timely processing and accuracy of claims and day to day interactions with any vendor...Serves as point of contact in researching and presenting Claim data in all legal issues Serves as company… more
- Scripps Health (San Diego, CA)
- …quarter of our employees have been with Scripps Health for over 10 years. The Director of HMO Payment ( Claims ) Services for Scripps Health Plan, leads claims ... * Mailroom experience. **Job:** **Finance* **Organization:** **Scripps Health Corp* **Title:** * Director , HMO Claims Services* **Location:** *Central San Diego… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Brennan Center for Justice (New York, NY)
- …with recruitment, retention, and workplace culture. QUALIFICATIONS + 10- 15 years of director level experience with SPHR or CCP certification + Knowledge of ... United States, is seeking a highly skilled and experienced Director of Human Resources (HR) to support the Chief...+ Manage all employee leave plans and workers' compensation claims , including but not limited to FMLA, short-term disability,… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... to have the one or all of the required certification OR willing to get certified within 1 year...claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic… more
- BronxCare Health System (Bronx, NY)
- …needed. - Participates in special projects and committees as determined by Director . Qualifications CERTIFICATION /LICENSURE : Registered Nurse or physician or a ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- Marriott (Plano, TX)
- …* Show dependability. **Education or Certification ** * Bachelor's Degree. * Certification from various Claims seminars. * Associate in Risk Management or ... Time **Located Remotely?** N **Position Type** Management **JOB SUMMARY** A Claims Unit Manager is responsible for overseeing the professional and administrative… more
- Whitney Young Health Center (Watervliet, NY)
- …complex or problem claims or insurance types as designated by the Director . Reviews payer coding policies and procedures to ensure that the department remains in ... and suggests solutions. Educates providers and gives feedback to Director of Revenue Cycle + Collaborates with practice managers...Certification from the AAPC as a Certified Professional Claims Coder required or obtained within 1 year from… more
- Unilever (El Segundo, CA)
- **Position Overview:** Reporting to the Director of Regulatory Affairs, the Certification Compliance Specialist will maintain the VMS Co-Op compliance systems to ... compliance with established regulatory and quality requirements with a focus on certification management. In this role you will demonstrate the behaviors of… more
- Martin's Point Health Care (Portland, ME)
- …2015. Position Summary Job Description Position Summary: Under the supervision of the Director of Health Plan Operations, the Claims Auditor II will perform ... Martin's Point, either verbally or through written communications, regarding questions related to claims , claims audits or other matters directed to the Audit… more
- CommonSpirit Health (Glendale, CA)
- …risk-related subject matter expert. + Ensures that risk management activities for claims are completed including timely claim identification and reporting, ... the Glendale, CA area and will travel within the Region. The Region Director Risk Management and Loss Prevention is responsible for orchestrating the successful… more
- MyFlorida (Port Charlotte, FL)
- …be licensed in Florida as Therapeutic Recreation Specialist, have the Certified Activity Director certification recognized by an accredited body or be willing ... employment history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. *Other vacant positions,… more
- Commonwealth of Pennsylvania (PA)
- Director of Farm Viability and Natural Resource Division (Conservation Program Manager) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4727556) ... Apply Director of Farm Viability and Natural Resource Division (Conservation...as other activities related to training, education, and professional certification programs. This position provides management oversight of tax… more
- USAA (Charlotte, NC)
- …standards. Makes recommendations for severity ratings to Senior Audit Manager (SAM)/ Director . May communicate with regulators. + Utilizes and provides guidance to ... audit, fraud consulting, etc.) for a large financial institution + Fraud-related certification (eg, CFE, CAMS, CAFS etc.) or undergraduate/advance degree in fraud,… more
- Fairview Health Services (St. Paul, MN)
- …Hospital Billing Charging, Resolute Professional Billing Claims , Resolute Hospital Billing Claims , OR ability to obtain certification within one year of ... **Overview** The Director of Revenue Cycle provides leadership and accountability...technology that results in leading practice clean and compliant claim creation. Leads employees and influences stakeholders to follow… more
- Crawford & Company (FL)
- …by client, internal required service levels by product and profitability of assigned claim teams through maximum cost containment. The Director will help drive ... disability and absence management services for a set of claim teams, which may include one or more of...as outlined by Crawford Educational Services. + Nationally accredited certification in a related profession such as Certified Disability… more
- City of New York (New York, NY)
- …projects using complex SQL algorithms and EDW data, analyzing data to identify claims that can be reclaimed for higher federal and state reimbursement rates, ... preparing claim adjustments to maximize federal and state funding, providing...providing technical support, financial analysis, data retrieval and financial claims support to DSS and other City agencies, responsible… more
- Providence (Irvine, CA)
- …specialist, project manager and patient relations staff in the dept. Manages claim activities with third party administrators (TPA) and defense attorneys. Analyzes ... on notification of event. + Reports investigative findings and manages claims with insurance carrier, third party administrator, and/or attorneys. + Prepares… more
- ADP (Miami, FL)
- **ADP is hiring a Sr Director , Tax - Audit & Finance** + _Are you a Sr Tax Director , skilled in providing strategic financial guidance to leadership?_ + _Are you ... this may be the role for you. As Sr. Director , Tax - Audit & Finance, you will lead...requests during audits and ensuring all employer tax and claims fiduciary, compliance and operational requirements are met. Like… more
- Atrius Health (Newton, MA)
- *SUMMARY* Under executive direction, the Associate Director Medex/DW Healthcare Economics Optum Massachusetts is responsible for all aspects of assessing, ... evaluating, and estimating outside medical expenses and claims data warehouse for Optum Massachusetts. Responsible for complex trend analysis and reporting to inform… more