- Sutherland Global Services (Columbus, OH)
- … Health and Wellness programs including a personal trainer dedicated to Sutherland + Health or health insurance claims experience + Knowledge of medical ... performance. Delivering measurable results._ This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much… more
- CVS Health (St. Paul, MN)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment 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 its center - our purpose… more
- Banner Health (AZ)
- …at the forefront of the health care transformation, planning the future of Banner Health . This role is remote for Arizona residents with a Monday - Friday ... claims . Updates claim files per documentation guidelines. Apprises Director of Claims and VP Business Health of case developments as appropriate. Obtains… more
- Elevance Health (Columbus, OH)
- ** Claims Representative I ( Health and Dental)** **Location:** Remote , within 50 miles of an Elevance Health pulse point. **Hours:** An 8-hour shift, ... to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the...spreadsheets, etc.) strongly preferred. + Previous experience working in health claims is strongly preferred. ** For… more
- Elevance Health (Atlanta, GA)
- **Title: Claims Representative I ( Health & Dental) - FEP** **Location:** This position will work a **hybrid model ( remote and office)** . The ideal candidate ... will live within 50 miles of our Elevance Health PulsePoint location at **740 W Peachtree St NW,...first 12 weeks of training. Start date: 3/10/2025.** The ** Claims Representative I** will be responsible for successfully completing… more
- Lincoln Financial Group (Columbus, OH)
- …Role at a Glance** We are excited to bring on a highly motivated Lead Supplemental Health Claims Associate to our Lincoln team! As a Lead Supplemental Health ... provide coaching, mentorship, and direction to our team of claims specialists . You may also deliver training...assistance program + A leadership team that prioritizes your health and well-being; offering a remote work… more
- Guardian Life (Columbus, OH)
- …by providing comprehensive medical reviews and analysis of long-term disability claims . The RN Clinical Consultant identifies restrictions, limitations and duration ... experience. **Candidate Responsibilities** The RN Clinical Consultant reviews long-term disability claims to determine the impact of claimants' medical condition on… more
- Lincoln Financial Group (Columbus, OH)
- …**The Role at a Glance** We are excited to bring on highly motivated STAT / PFL Claims Specialists to staff our ever-growing claims organization. As a STAT / ... diploma or GED + 1-2 years of experience in claims , leaves or customer service + Strong written and...assistance program + A leadership team that prioritizes your health and well-being; offering a remote work… more
- Trinity Health (Waterbury, CT)
- …If applicable, telecommuting (working remotely), must be able to comply with Trinity Health 's and the Region/HM Working Remote Policy. Hourly Pay Range: $27.42 ... analyzing physician/provider documentation contained in Complex Outpatient (CO)/Ambulatory Surgery health records to determine the principal diagnosis, secondary diagnoses,… more
- TEKsystems (Dallas, TX)
- …client, and master servicer rules and regulations * Performs regular reviews of all cases/ claims /documents on a regular basis * Assists Specialists in the ... Conducting in-line review or claims after they have been prepared for accuracy...for the employee and dependents)* Short and long-term disability* Health Spending Account (HSA)* Transportation benefits* Employee Assistance Program*… more
- Trinity Health (Newtown Square, PA)
- …If applicable, telecommuting (working remotely), must be able to comply with Trinity Health 's and the Region/HM Working Remote Policy. **Hourly Pay Range:** ... documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal… more
- Trinity Health (Livonia, MI)
- …If applicable, telecommuting (working remotely), must be able to comply with Trinity Health 's and the Region/HM Working Remote Policy. _The above statements are ... and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses,… more
- US Foods (Rosemont, IL)
- …there is a combination of three onsite days and the rest remote .** **Responsibilities:** **Insurance:** + Partner with Director, Risk Management in the placement ... process and determines appropriate response to requests for exceptions. ** Claims :** + Oversee the Workers' Compensation program including settlement authority,… more
- Stanford Health Care (Palo Alto, CA)
- …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** The Productivity & Quality Operations Manager reports ... measures and quality control. The Operations Manager will manage a team of specialists to provide and summarize productivity and quality reports to the Managers for… more
- Centene Corporation (Jefferson City, MO)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- Medical Mutual of Ohio (OH)
- **_Note, this is a fully remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** ... directly or forwards/escalates to other departments or PBM. Monitors paid claims for accuracy including for transition supply oversight. Ensures timely communication… more
- CommonSpirit Health (Erlanger, KY)
- …processes and organizational changes. + Serves as a resource for LOA Pay Advising Specialists including LOA and STD Claims Coordinators and LOA Intake teams. + ... **Overview** CommonSpirit Health was formed by the alignment of Catholic...Of Absence (LOA) and Short Term Disability (STD) leave claims and ensuring compliance with federal, state, local regulatory… more
- Ventura County (Ventura, CA)
- …County, CA Job Type Full-Time Regular Job Number 0840HCA-24AA (NW) Department Health Care Agency Division HCA Administration Opening Date 06/26/2024 Closing Date ... (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal,… more
- RWJBarnabas Health (Oceanport, NJ)
- …III (Medicare)Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding Quality Location: ... and/or RN also encouraged. Scheduling Requirements: + Position is primarily remote with occasional onsite requirement. Essential Functions: + Ensures the accuracy… more
- VNS Health (Manhattan, NY)
- OverviewSupports Pharmacy Services Specialists and Director of Pharmacy Services to perform Quality Improvement interventions, including maintenance of data ... of paid time off and 9 company holidays + Health insurance plan for you and your loved ones,...provided on job-required roles. + Flexible work schedule - Hybrid/ Remote opportunities available. What Will You Do + Assists… more