- Humana (Denver, CO)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Denver, CO)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation | Remote - Must reside in ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **TAKING CARE OF YOU** Flexible work… more
- Sedgwick (Denver, CO)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Denver, CO)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Highmark Health (Denver, CO)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Nucor Steel Auburn, Inc. (Denver, CO)
- …located at the Nucor Fabrication location. Manage bid lists daily; print & review reports, incoming transmittals and plans from customers; Track the assignment of ... has full knowledge of the market. + Assist in the resolution of claims and disputes between Nucor Rebar Fabrication and customers. + When necessary, assist… more
- Ryder System (Denver, CO)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Highmark Health (Denver, CO)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- CVS Health (Denver, CO)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- State of Colorado (Denver, CO)
- …performed by the Fiscal Agent. + Leverage data from enrollment information and claims data, the position leads the development of strategies for provider capacity ... on large computer systems, preferably Health IT systems like claims processing engines or care/case management platforms. OR Education...appeal with the State Personnel Board or request a review by the State Personnel Director. An appeal or… more
- Otsuka America Pharmaceutical Inc. (Denver, CO)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- State of Colorado (Denver, CO)
- …up pharmaceuticals and paperwork from the units, process Medicare Part D claims , coordinates pickup and removal of pharmaceutical wastes with vendor, answering ... to treatment units, fill prescriptions, process Medicare part D claims , and issue pharmaceutical credits back to clients: +...appeal with the State Personnel Board or request a review by the State Personnel Director. An appeal or… more
- Prime Therapeutics (Denver, CO)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- University of Colorado (Denver, CO)
- …the Office of the State Architect. Additionally, the Director serves as a representative for CU Denver on various internal and external boards and committees and ... of consultant teams in planning, design, construction, estimating, code review , and others as applicable. **Director of Design and...with consultants and contractors and assist others in the claims and appeals process as needed. + Serve as… more
- State of Colorado (Denver, CO)
- …visits, reviewing of reports for contract compliance, and evaluating performance. + Review and approve/deny payment of claims for grant reimbursement of ... of this announcement will not be considered in the review of your application. In addition, part-time work will...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Denver, CO)
- …path and flexible working arrangements, click the link below to review additional benefits and perks Careers (https://cdphe.colorado.gov/careers) Some positions may ... from other data sources (eg, prevalence surveys, Medicare, or claims data). + Measure the impact of antimicrobial stewardship...from consideration during the selection process may request a review by the State Personnel Director. As an applicant… more
- Fresenius Medical Center (Denver, CO)
- …determining project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global ... the consolidation, analysis and reporting of commercial revenue. Develops standards of review and analysis to facilitate accurate and timely analysis of all… more
- Burns & McDonnell (Denver, CO)
- …and consult with the Legal Department as required. + Expert in the review , negotiation, approval, and execution of prime contracts, subcontracts, and change orders. ... Request for Information (RFI's), submittals, change management, contract closeout, and claims mitigation. + Analyze and approve internal and external reports… more
- Adams 12 Five Star Schools (Thornton, CO)
- …each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations ... for certified staff; completing, submitting and coordinating workers' compensation claims ; maintaining yearly evaluation schedules and preparing evaluation packets;… more
- RxBenefits (Denver, CO)
- …team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting. The successful Pharmacy Pricing Senior Manager will ... across internal stakeholders to foster collaborative and efficient work products + Review for accuracy and finalize all current account pricing comparisons for… more