- Lincoln Financial Group (Annapolis, MD)
- …**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
- Trustmark (Annapolis, MD)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Annapolis, MD)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
- Takeda Pharmaceuticals (Annapolis, MD)
- …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
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... **Resp & Qualifications** Although this position is REMOTE , candidates are preferred to live in the MD, DC, VA, PA area in order to travel into the offices on… more
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... that will target claim overpayment scenarios. Performs analysis on claims , provider data, enrollment data, medical policies, claim payment...and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to… more
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... to CareFirst indemnity business, ensuring that all appropriate materials, related claims , contracts, payment vouchers are included. Develop a summary/assessment of… more
- CareFirst (Baltimore, MD)
- …that makes him/her ineligible to perform work directly or indirectly on health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... to meet Corporate Project deliverables. Work with Quality Improvement, Legal, Care Management, Internal Audits and other departments to identify and support… more
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... resolution, and interface monitoring/ resolution four our clinical platform, Guiding Care , supporting Care Management, Utilization Management, and Appeals and… more
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... Collaborates with other business units: Utilization Management, Case Management, Claims , Quality Management and Compliance. The Nurse, Quality Review position… more
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... physician review by compiling clinical, contractual, medical policy and claims information along with corporate and appellant correspondence. Formulates… more
- CareFirst (Baltimore, MD)
- …cost of care savings projects is great and/or govt programs claims knowledge. **ESSENTIAL FUNCTIONS:** + Interpret business needs and issues by gathering, ... to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is...Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of… more
- CareFirst (Baltimore, MD)
- …(CPCS) **Experience:** 3 years physician credentialing experience or health insurance/managed care operations experience in a customer service, claims , billing ... to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is...Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of… more
- Sevita (Baltimore, MD)
- …more than 50 years, our team members have provided home and community-based health care for adults, children and their families across the United States. As a member ... and experience a career well lived. **Litigation and Risk Associate General Counsel** Do you have a law degree...help develop systems and procedures to assure optimal quality care for the individuals we serve. This role is… more
- Cardinal Health (Annapolis, MD)
- …products are used. **What this position contributes to Cardinal Health:** The Associate Director, Access and Patient Support (APS) is responsible for the tactical ... of collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Trustmark (Annapolis, MD)
- …benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and ... office in Lake Forest, IL for 3 days. Fully remote candidates are also welcome to apply.*_** Brand: Trustmark...FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up Care for Children, Adults and Elders and many health… more
- Humana (Annapolis, MD)
- …**Use your skills to make an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience in medical auditing & coding ... 6 or more years of work experience related to claims with an understanding claims lifecycles/healthcare revenue...team of offshore associates **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring… more
- Humana (Annapolis, MD)
- …for our members and providers, all while driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide ... strategic direction to drive appropriate care , with the aim of reducing waste and overuse...to bring forth a pipeline of potential initiatives. **Location:** remote In this lead role you'll have the opportunity… more
- Humana (Annapolis, MD)
- …first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( 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 (Annapolis, MD)
- …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