- Lincoln Financial Group (Salt Lake City, UT)
- …**Requisition #:** 74121 **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
- Humana (Salt Lake City, UT)
- …of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims adjudication to support medication ... & LTC hospice patients and reconcile historic billing issues. **Location: Remote US** **Shift: Monday-Friday 2:30pm-11pm EST. Flexibility to work alternating… more
- Humana (Salt Lake City, UT)
- …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 (Salt Lake City, UT)
- …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
- Molina Healthcare (Salt Lake City, UT)
- …Technician** who is State Licensed/Certified and/or PTCB certified. This role is 100% remote , and the hours will be **Mon-Fri 10am to 630pm Pacific Standard Time** ... medical necessity for medications along with assisting with pharmacy claims . **Highly qualified candidates for this role will have...work within several computer systems at once + Managed care experience + High level of communication skills, both… more
- Molina Healthcare (Salt Lake City, UT)
- …**Pharmacy Technicians** who are State Licensed/Certified and/or PTCB certified. This role is 100% remote , and the hours will be **Mon-Fri 9am to 530pm or 11am to ... medical necessity for medications along with assisting with pharmacy claims . **Highly qualified candidates for this role will have...work within several computer systems at once + Managed care experience + High level of communication skills, both… more
- Molina Healthcare (Salt Lake City, UT)
- …who is **BOTH** State Licensed/Certified and Nationally certified. This role is 100% remote , and the hours will be **Mon-Fri 11am to 730pm Central Standard Time** ... at once, MS Note experience a plus + Managed care experience + High level of communication skills, both...High School Diploma or GED equivalent **Preferred Education** : Associate degree **Required Experience** : 2 years' experience as… more
- Molina Healthcare (Salt Lake City, UT)
- …to, and the appropriate approvals and escalations are achieved. Coordinates with both the Associate Vice President of Fraud, Waste and Abuse (FWA) and Associate ... Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims *...Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS,… more
- Merck (Salt Lake City, UT)
- **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
- University of Utah Health (Salt Lake City, UT)
- …Health exists to enhance the health and well-being of people through patient care , research and education. Success in this mission requires a culture of ... and 25+ facilities across Utah. This coordinator role will work with reports/ claims data, assist with appeals and grievances, and ideally requires experience with… more
- Humana (Salt Lake City, UT)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Salt Lake City, UT)
- …operational efficiency, reduce manual processes, and improve accuracy in insurance claims processing, policy management, and other key areas. A strong background ... solutions to streamline and automate insurance-related processes, such as claims processing, policy administration, and customer service operations. + **Technical… more
- Humana (Salt Lake City, UT)
- …established guidelines/procedures. **What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate ... **Use your skills to make an impact** **WORK STYLE:** Remote , work at home with minimal travel (for on-sites,...What it takes to Succeed** + Minimum of an Associate 's degree + Minimum 2 years of investigative and/or… more
- Humana (Salt Lake City, UT)
- …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
- Intermountain Health (Salt Lake City, UT)
- …and reconsideration needs. Promotes the quality and cost effectiveness of patient care using clinical acumen in preparation of documentation, audits of patient ... + Collaborate with various caregivers within or outside department, provider networks and clinical care site partners and care team to coordinate patient care… more
- University of Utah Health (Salt Lake City, UT)
- …Health exists to enhance the health and well-being of people through patient care , research and education. Success in this mission requires a culture of ... serve as a resource for other coders. This position is not responsible for providing care to patients. Corporate Overview: The University of Utah is a Level 1 Trauma… more
- Humana (Salt Lake City, UT)
- …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