- Lincoln Financial Group (Washington, DC)
- …**Requisition #:** 72954 **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
- Trustmark (Washington, DC)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… 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
- RTX Corporation (Arlington, VA)
- Date Posted: 2024-10-30 Country: United States of America Location: RCO99: RTN Remote , Colorado Position Role Type: Remote At Raytheon, the foundation of ... Chain (SC) Legal Advisor, who will report to the Associate Director, Raytheon SC Advising. The SC Advisor provides...information agreements, and other agreement types. This position is remote ; the ideal candidate will be located within 50… more
- Ankura (Washington, DC)
- …excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and ... and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations....develop project work plans as requested . Understands health care compliance concepts, issues, and how to research and… more
- Westat (Rockville, MD)
- **27513BR** **Job Title:** Principal Research Associate - Economist - CMS **Location:** MD - Rockville **Job Description:** Westat is an employee-owned corporation ... and experiences of our employees. Westat is seeking a Principal Research Associate - Economist with expertise in health services and policy research. The… more
- Westat (Rockville, MD)
- …experience/task coordination and/or cooperative agreements. + Demonstrated experience using health care claims data in behavioral health research studies. ... **27458BR** **Job Title:** Principal Research Associate - Behavioral Health **Location:** MD - Rockville...days on-site at a Westat office location is preferred, remote work arrangements will be considered. **Job Responsibilities:** +… more
- Sprinklr (Washington, DC)
- …a law firm setting, including experience with copyright and patent infringement claims , intellectual property matters, and federal securities claims ._** + ... hiring a Legal Counsel to join Sprinklr's Legal team, reporting to the Associate General Counsel, Employment & Litigation. The Legal Counsel will have primary daily… 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)
- …**Use your skills to make an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience in medical auditing & coding ... 6 or more years of work experience related to claims with an understanding claims lifecycles/healthcare revenue...team of offshore associates **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring… more
- Humana (Washington, DC)
- …for our members and providers, all while driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide ... strategic direction to drive appropriate care , with the aim of reducing waste and overuse...to bring forth a pipeline of potential initiatives. **Location:** remote In this lead role you'll have the opportunity… 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
- CareFirst (Washington, DC)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... impression and emerging areas of liability (eg, vicarious liability of managed care organizations). + Managing External Counsel.When referral to outside counsel is… more
- Humana (Washington, DC)
- …populations served in target growth markets. **Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions for key ... Medicaid programs and subpopulations.** Areas of focus include Care Management, Quality Improvement, Utilization Management, Population Health, Social Determinants… more
- Humana (Washington, DC)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... 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 **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Trustmark (Washington, DC)
- …work on-site at our office in Lake Forest, IL for 3 days. Fully remote candidates are also welcome to apply.*_** Assess current state business processes and ... benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and… more
- Humana (Washington, DC)
- …researches/reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or recovery. Analyzes, enters ... knowledge. **Use your skills to make an impact** **WORK STYLE:** 100% remote /work at home. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day,… more
- Humana (Washington, DC)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more