- Kaiva Tech (Washington, DC)
- …and quality assurance standards. Participate in required training related to claims adjudication, program operations , and system usage. Maintain timely, ... Kaiva Tech, LLC is seeking Licensed Attorney - Claims Reviewer Location: Washington, DC Clearance: 5C Public Trust Position Type: Full-Time, Hybrid/Remote Position… more
- FM (Reston, VA)
- …and make a difference in the future - yours, your clients', and the company's? The Claims team within our DC Operations in Reston (VA) has a great opportunity ... solutions. FM helps clients maintain continuity in their business operations by drawing upon state-of-the-art loss-prevention engineering and research;...summer 2026! When you join FM as a Property Claims intern, you can bring your talents to life… more
- FM (Norwood, MA)
- …and make a difference in the future - yours, your clients', and the company's? The Claims team within our Boston Operations has a great opportunity for you for ... solutions. FM helps clients maintain continuity in their business operations by drawing upon state-of-the-art loss-prevention engineering and research;...Summer 2026! When you join FM as a Property Claims intern, you can bring your talents to life… more
- Commonwealth Care Alliance (Boston, MA)
- …systems (eg, Salesforce) and provider relationship management tools. - Understanding of claims operations , utilization management, and quality programs as they ... medical management, and analytics teams to advance provider network operations , education, and performance improvement. The Provider Relations Director reports… more
- Lyric (Newtown Square, PA)
- …consult with and inform Lyric's clients. + Familiarity with affordability, claims operations , payment integrity, utilization management, medical policy and/or ... ambassador to payer clients, engaging directly with medical directors, clinical operations executives, and CMOs. + Build trusted advisory relationships that expand… more
- Commonwealth Care Alliance (Boston, MA)
- …and authorization process highly desired. + Experience with and understanding of Claims operations preferred. **Knowledge, Skills & Abilities (Required)** + ... with and visits to provider sites. Visits may include regular operations meetings, staff education, provider orientations, and appreciation events. + Facilitate… more
- Alameda Health System (San Leandro, CA)
- …access (scheduling, registration, and referral coordination and revenue cycle operations (billing, claims , denials, authorizations, registration related edits, ... Director, Ambulatory Access & Revenue Operations + San Leandro, CA + Fairmont Hospital...- scheduling, registration, and referral coordination. Revenue - billing, claims , denials, authorization, and registration impact Determines access and… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …and manages real-time escalations as needed + Works collaboratively with Claims , Eligibility, Provider Relations, Business Operations and other Health ... Utilization Management experience + General understanding of health plan operations , claims and eligibility systems, claims processing, and health… more
- FLORIDA FARM BUREAU (Tallahassee, FL)
- SUMMARY : Responsible for handling all assigned claims to a proper conclusion. ESSENTIAL DUTIES AND RESPONSIBILITES : Include the following. Other duties may be ... assigned. Investigate, validate, evaluate, negotiate, and settle all claims as assigned. Maintain claim files and follow departmental reporting procedures. Submit… more
- FLORIDA FARM BUREAU (Fort Myers, FL)
- SUMMARY: Responsible for handling all claims in assigned territory to a proper conclusion with a starting salary of $53,800 and a company car. ESSENTIAL DUTIES AND ... duties may be assigned. Investigate, validate, evaluate, negotiate, and settle all claims as assigned. Submit reserve recommendations on assigned claims .… more
- FM (Johnston, RI)
- …various internal sources via the company's underwriting, engineering, client services, marketing, claims , and operations data. You will be expected to ... understand, interpret, and communicate the impact to stakeholders through various forms of communication. We also aim to create and share guidelines across the organization for data visualization and reporting best practices. You will act as an ambassador to… more
- Lyric (Newtown Square, PA)
- …(HIPAA, HITRUST, HL7, FHIR) is a plus? + Background in healthcare payer operations or claims processing systems?is preferred + Relevant certifications in cloud ... platforms or healthcare technology standards?is a plus The US base salary range for this full-time position is: $122,425.00 - $183,638.00 The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the… more
- Coty (New York, NY)
- …projects in appropriate systems, forums and costing/budgeting exercises. **Support to Operations ** + Manage procurement related claims /issues for your brand ... New Product Development & Operations Buyer - Philosophy **NEW PRODUCT DEVELOPMENT & OPERATIONS BUYER - PHILOSOPHY** **PROCUREMENT - NEW YORK, NEW YORK** **COTY… more
- Towne Park (San Antonio, TX)
- …initiatives and Towne Park cultural perspectives are incorporated within the area's operations . The Senior Account Manager is responsible for escalating issues to ... the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover. Manages payroll and ensures that controls… more
- Tutor Perini (Sylmar, CA)
- …on experience. Tutor Perini Corporation is seeking a **Director of Finance Operations ** for our office in **Sylmar, CA** . **About Tutor Perini Corporation** ... **_Extraordinary Projects need Exceptional Talent_** **DESCRIPTION** The **Director of Finance Operations ** will report to the **Vice President of Finance … more
- CSL Behring (King Of Prussia, PA)
- …(eg IQVIA claims data) -Experience across all areas of sales operations including sales incentive compensation design and operations , customer targeting, ... As the Senior Director of Sales Operations , Data & COE you will play a...with responsibility for leading all aspects of sales force operations across the entirety of CSL Behring's US portfolio… more
- Fresno First Bank (Fresno, CA)
- …responsive, and have a sense of urgency. About the Position : The Central Operations Specialist III role is vital for executing all Central Operations daily ... will be responsible for training team members in all areas of Central Operations . This position requires accurate and timely completion of tasks, strong attention to… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Under the supervision of the UM Operations Manager, the UM Operations Trainer's primary job function is to support Utilization Management ... operations by training non-clinical staff on how to successfully...answering the phone (including all calls regarding authorization processing, claims related phone calls, and any other calls received… more
- AdaptHealth LLC (Santa Barbara, CA)
- …If you are a good match, make an application. Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple ... each region's individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth… more
- Banc of California (Santa Ana, CA)
- …are processed appropriately at the branch and/or corporate levels, or credit card operations management Performs a variety of Operations Support functions; such ... on-us & Unusual items, Stop payment, ATM/Mobile/RDC Deposits, Check Claims , Fraud alerts for Wire, ACH & Debit Card,...training. Work related experience should consist of a central operations , or deposit operations , and/or branch … more
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