- Humana (Nashville, TN)
- …and identify opportunities to for provider education. + Ensures compliance with Oklahoma's Managed Care Contractual requirements for provider relations, such as ... first** Humana Healthy Horizons in Oklahoma is seeking a Claims Research & Resolution Lead to lead a team...+ Experience with Oklahoma Medicaid. + Thorough understanding of managed care contracts, including contract language and… more
- Humana (Nashville, TN)
- …regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional ... interpretation. The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work various tasks or… more
- Prime Therapeutics (Nashville, TN)
- …is client facing, and acts as a strategic liaison between the business and vendor partners to ensure the Strategic Solutions roadmap is created, managed , and ... platforms and products + Experience using queries, thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly… more
- Centene Corporation (Nashville, TN)
- …external/internal reconciliation) experience in healthcare industry or 3+ years of managed care IT experience. Advanced knowledge of Microsoft Applications, ... Acceptance, Quality testing or Data Reconciliation in healthcare, preferably managed care or Medicaid. Knowledge of Amisys...care or Medicaid. Knowledge of Amisys or other claims system, qTest or any other agile test case… more