• Claims Care Associate

    Lincoln Financial Group (Harrisburg, PA)
    …**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
    Lincoln Financial Group (09/18/24)
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  • Associate Director, Global Labeling Lead…

    Takeda Pharmaceuticals (Harrisburg, PA)
    …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
    Takeda Pharmaceuticals (07/18/24)
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  • RN Sanction Specialist - EMTALA and Sanction…

    Kepro (Harrisburg, PA)
    …experienced with maintaining compliance with EMTALA regulations. *Position is remote * Job Responsibilities: + Maintain lines of communication (verbal/written) ... + 5+ years of clinical experience in either a short-term acute care hospital or skilled nursing facility required Preferred Qualifications/Experience: + BSN,… more
    Kepro (08/30/24)
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  • Associate Director, Signal Detection…

    J&J Family of Companies (Harrisburg, PA)
    Associate Director, Signal Detection Scientist - 2406212640W **Description** Johnson and Johnson is currently seeking an ** Associate Director, Signal Detection ... NJ; Raritan, NJ; Horsham, PA; OR High Wycombe, UK. Remote work options in the US or UK may...international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and… more
    J&J Family of Companies (09/19/24)
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  • Inpatient Medical Coding Auditor

    Humana (Harrisburg, PA)
    …for an experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and ... payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
    Humana (09/20/24)
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  • Clinical Research Scientist 2

    Humana (Harrisburg, PA)
    …health first** Humana's Clinical Analytics Team is seeking a Research Scientist 2 ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
    Humana (09/14/24)
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  • System Engineer III

    NASCO (Harrisburg, PA)
    …and system issues, plus research and resolution of Model Office and Production issues so claims can be paid accurately and timely + Provides support to NASCO and the ... others being over the phone. (required if person is remote ) + Minimum 8 years of proven experience in...mentoring System Engineers. + In-Depth knowledge of the Health Care industry + Extensive working knowledge of and capabilities… more
    NASCO (09/17/24)
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  • Senior Business Intelligence Engineer

    Humana (Harrisburg, PA)
    …Science, finance, Statistics, Economics or related field + Experience working with Claims , Billing and Reconciliation or related healthcare data + Expertise in ... and Root Cause Analysis (RCA) experience **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring process for this… more
    Humana (08/30/24)
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  • Coordinator, Intake Utilization Management

    Evolent Health (Harrisburg, PA)
    …role either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievance. - **Required** ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...with other Client Service Leaders including our Client Service Associate Director and Director may also be available. **What… more
    Evolent Health (09/20/24)
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  • Medical Director - Grievances and Appeals

    Humana (Harrisburg, PA)
    …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
    Humana (09/17/24)
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  • Pharmacy Technician, IPU

    Humana (Harrisburg, PA)
    …client / prescriber interaction + Assist local pharmacies in adjudication of claims for emergent need medications + Ability to appropriately escalate urgent requests ... tasks + Must possess excellent work habits + Ability to oversee workflow in remote sites + Ability to exhibit flexibility in tasks/scheduling, as requested. + Able… more
    Humana (08/01/24)
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