- RWJBarnabas Health Corporate Services (Oceanport, NJ)
- …including the candidate's educational background, skills and professional experience. The position is remote , but candidates must be based in New Jersey, New York or ... Requirements: Monday-Friday, 40 hour a week salaried position 8:00am-4:30pm Remote however must reside in NJ, PA, or NY...Quality Officer's coding analysis is reviewed by the Coding Specialists on a biannual basis. The consequences of incorrect… more
- NJM Insurance (Trenton, NJ)
- …growth and success of our policyholders' business operations. To meet these expectations, WC Claims Specialists are supported by a dedicated call center who can ... and agents in that area. This is a 100% remote position which includes virtual claims handling...employer match up to 8% and additional service-based contributions, Health , Dental, and Vision insurance, Life and Disability coverage,… more
- Humana (Helena, MT)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... well as a focus on collaborative business relationships, value-based care, population health , or disease or care management. Medical Directors support Humana values… more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... as well as a focus on collaborative business relationships, value based care, population health , or disease or care management. **Use your skills to make an impact**… more
- Centene Corporation (Sacramento, CA)
- …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
- CareFirst (Baltimore, MD)
- …technology support, Utilization Management (UM) operations, Clinical Product Configuration, Health Plan Claims /Authorization workflows, or related healthcare ... projects as needed. Maintain a strong working knowledge of the FACETS claims -to-authorization matching workflow and utilize this knowledge to identify and resolve… 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
- The Cigna Group (Newburyport, MA)
- …insurance, and payment information. + _Be a team player_ - Escalate complex claims to the Sr. Billing & Reimbursement Specialists for appropriate action. ... of benefits, with a focus on supporting your whole health . Starting on day one of your employment, you'll...day one of your employment, you'll be offered several health -related benefits including medical, vision, dental, and well-being and… more
- The Hershey Company (IN)
- …and off-site medical providers, including, but not limited to, physical therapists, specialists , and/or Nurse Case Managers. * / Claims Management/* * Timely ... *Whitestown, Indiana - Onsite, 5 days per week (No Remote ) * Job Summary:* Reporting to the EHS manager,...Job Summary:* Reporting to the EHS manager, the Occupational Health Nurse will provide professional and comprehensive health… more
- University of Rochester (Albany, NY)
- …to all and is a place where all can thrive. **Job Location (Full Address):** Remote Work - New York, Albany, New York, United States of America, 12224 **Opening:** ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- Health Care Service Corporation (Tulsa, OK)
- …Inquiries Involving Member*S Requests For Appeals. May Train And Mentor Less Experienced Appeals Specialists . THIS IS NOT A FULLY REMOTE POSITION. THIS IS A ... or GED. * 3 years' experience in a customer service role OR in a health insurance or medical environment. * Knowledge of medical terminology to include coding. *… more
- Virtua Health (Moorestown, NJ)
- At Virtua Health , we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to ... care you need. Whether that's wellness and prevention, experienced specialists , life-changing care, or something in-between - we are...or something in-between - we are your partner in health devoted to building a healthier community. If you… more
- Reno Orthopedic Center (Reno, NV)
- …enthusiastic and dedicated team member to answer inbound calls regarding billing and insurance claims at our Main location - 555 N. Arlington Ave. Please note: This ... is an onsite position. It is not remote . Who are we? At Reno Orthopedic Center (ROC),...member's voice matters. We offer a fully integrated musculoskeletal health campus with on-site surgery, advanced imaging, therapy, urgent… more
- Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
- …+ **Team Management** : Lead a high-performing team of operational specialists , including webinar production, medical writing, and customer service engagement ... specialists . + **Data-Driven Insights** : Utilize data analytics and...thinker with a results-oriented mindset. + Experience working in remote or hybrid teams is a plus **Competencies** **Accountability… more
- BayCare Health System (Tampa, FL)
- …largest employers within the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the state of Florida, Georgia, South Carolina, or ... Monday - Friday The **Inpatient** **Coding Auditor** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + The Inpatient Coding… more
- Centene Corporation (Jefferson City, MO)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Review 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
- Abbott (Livermore, CA)
- …large enterprise. + Prior experience with SOX, PCI, and HIPAA compliance + **Insurance claims / Health Care Industry experience** **Misc: This role is based at our ... career you dream of. + Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year + An excellent… more
- Commonwealth Care Alliance (Boston, MA)
- …Alliance's (CCA) diverse provider community - including physician, hospital, behavioral health , community-based, LTSS, and HCBS providers. This individual serves as ... relationships with providers across all specialties -, physician, hospital, behavioral health , community based, and ancillary providers and their staff. + Serve… more
- Otsuka America Pharmaceutical Inc. (Rockford, IL)
- …the corporate philosophy: "Otsuka-people creating new products for better health worldwide." Otsuka researches, develops, manufactures and markets innovative ... unmet medical needs and nutraceutical products for the maintenance of everyday health . In its evolved customer engagement model, a Neuroscience Specialist engages… more
- Otsuka America Pharmaceutical Inc. (Jackson, MS)
- …the corporate philosophy: "Otsuka-people creating new products for better health worldwide." Otsuka researches, develops, manufactures and markets innovative ... unmet medical needs and nutraceutical products for the maintenance of everyday health . In Otsuka's evolved customer engagement model, a Neuroscience LTC Specialist… more
