• Quality Assurance Specialist III…

    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 ... and procedures. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and… more
    CareFirst (01/29/25)
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  • Medical Director-- Claims Management

    Humana (Washington, DC)
    …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
    Humana (01/28/25)
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  • Associate Director, Global Labeling Lead…

    Takeda Pharmaceuticals (Washington, DC)
    …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 (01/15/25)
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  • Health Care Navigator - Evernorth Heath…

    The Cigna Group (Annapolis, MD)
    …have a background in customer service or experience in healthcare, specifically benefits and claims processing, you might be the perfect fit to join our team as a ... Care Navigator Representative. As a Care Navigator,...driving a consistently accurate quality of service. **QUALIFICATIONS:** + Associate degree or higher required and/or 4+ years' work… more
    The Cigna Group (01/28/25)
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  • Quantitative Research Associate (Medicare…

    Abt Global Inc. (Rockville, MD)
    …career and their experience conducting research on post-acute care , nursing home health care policy, and health care claims data to play key technical ... homes or other post-acute care settings, health care policy. + Use Medicare claims data...Abt Global will never ask candidates for money in exchange for an offer of employment. _ _\#LI-CO1_ #LI- Remote more
    Abt Global Inc. (01/23/25)
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  • Senior Regulatory Compliance Analyst…

    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 (01/10/25)
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  • Provider Contracting Specialist ( Remote )

    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 (01/24/25)
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  • Clinical Pharmacist ( Remote )

    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 area in order to travel into the offices.**… more
    CareFirst (02/01/25)
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  • Central Billing Associate

    Erickson Living (Baltimore, MD)
    …also maintains records of invoices, debit, and credits and oversees the tracking of all claims . This is not a remote or hybrid position. **​** **How you will ... Location: Erickson Senior Living The Central Billing Associate is responsible for securing revenue by verifying...make an impact:** + Review claims for coding and billing accuracy. Performs Insurance follow-up… more
    Erickson Living (01/25/25)
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  • Project Coordinator/Stop Loss Intern - MD, DC, VA…

    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 ... understand the business processes of Stop Loss insurance, including claims , reporting, and marketing. + Learn and become a...and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to… more
    CareFirst (02/01/25)
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  • Medical Coding Auditor

    Humana (Washington, DC)
    …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes,...**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
    Humana (01/30/25)
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  • Benefit Analyst

    T. Rowe Price (Owings Mills, MD)
    …model. The team manages the myHR portal which serves as a self-service associate platform for HR information such as benefits, payroll, HR policies, other HR ... educate peers and associates on benefits programs, maintaining and auditing associate data/records to ensure accuracy, conducting research and providing appropriate… more
    T. Rowe Price (01/07/25)
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  • Lead Research Scientist

    Humana (Washington, DC)
    …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 (01/03/25)
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  • Field Reimbursement Specialist

    Amgen (Washington, DC)
    …in the public or private third-party access arena or pharmaceutical industry in managed care , clinical support, and/or sales OR Associate degree AND 10 years of ... insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate offices using approved materials + Review… more
    Amgen (01/26/25)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Washington, DC)
    …first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... 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 \#LI- Remote **Scheduled Weekly Hours** 40… more
    Humana (01/07/25)
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  • Senior Database Engineer

    Humana (Washington, DC)
    …working with health insurance operations related data to include enrollment, claims , billing and Reconciliation and/or contact center (Call center) data **Additional ... Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring...(collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and… more
    Humana (01/23/25)
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  • Digital Medicine, Senior Manager

    Amgen (Washington, DC)
    …with real-world data (RWD) such as electronic health records (EHR) and claims data; providing trial activities at non-traditional sites, including virtual visits, ... the biopharmaceutical industry or equivalent health sciences field. Or Associate 's degree and 10 years of experience in digital...us** As we work to develop treatments that take care of others, we also work to care more
    Amgen (02/01/25)
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  • Senior Data Scientist

    Amgen (Washington, DC)
    …**Or** Bachelor's degree and 4 years of experience in a quantitative field **Or** Associate degree and 8 years of experience in a quantitative field **Or** High ... eg, clinical trial data, electronic medical records, and insurance claims ; or Bioscience's data, eg, protein or small molecule...us** As we work to develop treatments that take care of others, we also work to care more
    Amgen (11/28/24)
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  • Data and Reporting Professional

    Humana (Washington, DC)
    …Degree + CAS, MTV, PAAG, or APEX systems experience + Claims experience + Provider data management data loading/analysis/review **Additional information** ... ongoing interruptions to protect member PHI / HIPAA information. This is a remote position \#PPNO **Scheduled Weekly Hours** 40 **Pay Range** The compensation range… more
    Humana (01/29/25)
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  • Director of Human Resources - Audi Field

    Compass Group, North America (Washington, DC)
    …the location HRIS system + Ensuring the timely processing of all unemployment claims + Plans the team's activity to deliver against medium-term objectives + Managing ... in a Human Resources leadership role + Experience leading remote teams is preferred + Experience managing large scale...At Levy, team = family. And we'll always take care of family, learn more about Levy benefits offered.… more
    Compass Group, North America (12/18/24)
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