- Lincoln Financial Group (Washington, DC)
- …**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 (Washington, DC)
- …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 (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
- 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
- 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
- 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 ... handles day to day review of professional and institutional claims and provider appeals that require medical review to...and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to… more
- 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 (Baltimore, MD)
- …that makes him/her ineligible to perform work directly or indirectly on lth care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... in projects. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and compliance… more
- Merck (Washington, DC)
- **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
- Westat (Rockville, MD)
- …experience/task coordination and/or cooperative agreements. + Demonstrated experience using health care claims data in behavioral health research studies. ... **27900BR** **Job Title:** Principal Research Associate **Location:** MD - Rockville **Job Description:** Westat...days on-site at a Westat office location is preferred, remote work arrangements will be considered. **Job Responsibilities:** +… more
- 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
- Humana (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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 (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
- Intermountain Health (Washington, DC)
- …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
- 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
- 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
- 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