• RCIS Crop Claims Specialist, MO: Clark,…

    Zurich NA (Jefferson City, MO)
    …workload(s) , participate on CAT team and/or provide remote assistance for the CROP Claims Care Center calls and/or CCP Claims + RCIS Crop Adjuster ... RCIS Crop Claims Specialist, MO: Clark, Knox, Lewis, or Scotland...Office Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LC1 #LI- ASSOCIATE more
    Zurich NA (11/15/24)
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  • Medical Director-- Claims Management

    Humana (Jefferson City, MO)
    …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 (Jefferson City, MO)
    …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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  • Associate Quality Practice Advisor

    Centene Corporation (Jefferson City, MO)
    …on workplace flexibility. CLINICAL LICENSE STRONGLY PREFERRED THIS POSITION IS REMOTE FOR MISSOURI OCCASIONAL TRAVEL TO PROVIDER OFFICES IF NEEDED **Position ... improve provider performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Assists in delivering provider specific metrics and… more
    Centene Corporation (01/10/25)
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  • Medical Coding Auditor

    Humana (Jefferson City, MO)
    …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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  • Lead Research Scientist

    Humana (Jefferson City, MO)
    …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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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Jefferson City, MO)
    …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 (Jefferson City, MO)
    …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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  • Data and Reporting Professional

    Humana (Jefferson City, MO)
    …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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