- Robert Half Legal (Media, PA)
- Description We are seeking a Claims Advocate Attorney to join our team based in Media, Pennsylvania. In this role, you will serve as a key point of collaboration ... to inquiries from clients, broking department, and insurers on claims , coverages, and exposures. * Advocate for...client inquiries. * Coordinate, prepare for, and attend claim review meetings on selected accounts. * Monitor claims… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …in the Enrollment, Billing and/or Reconciliation processes. The analyst will review documentation, work items in queues and correct errors, identify trends ... for a fast-growing healthcare organization This will be up to 5 month contract position with target start date of 9/16/2024 ESSENTIAL DUTIES AND RESPONSIBILITIES… more
- MetroLink (Los Angeles, CA)
- …proposal protests. + Review for compliance against terms & conditions of contract invoices and payment to contractors. + Review and evaluate existing ... Senior Contract & Compliance Administrator Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4642379) Apply Senior Contract & Compliance… more
- Air Force Materiel Command (Arlington, VA)
- …organization with unlimited warrant authority. Serves as the Competition Advocate , Business/ Contract Clearance Authority, and/or Small Business Representative ... a Contracting Officer. Plans work to be accomplished by subordinates ( contract specialist), sets and adjusts short/long-term priorities, and prepares schedules for… more
- The Cigna Group (Bloomfield, CT)
- …+ Lead and/or advise on complex national provider agreements, negotiations, legal review and signature processes + Manage and/or support the agreement and amendment ... preparation processes, as assigned + Responsible for accurate and timely contract loading including effective interfacing with matrix partners for network… more
- Air Combat Command (Langley AFB, VA)
- …history, and administrative determinations and resolution of mistakes in bids, protests, contract disputes, contract claims , and fraud remedies. Serves ... laws, regulations, and policy. Performs an independent professional legal review of contractual documents, contractual forms, and specialized contractual provisions… more
- Interactive Government Holdings, Inc. (Fort Knox, KY)
- …regulations and guidelines set in the Performance Requirements Summary for this contract . Responsible for overseeing each section's claims , inquiries and/or RFIs ... our programs serve. IGH has a national and international contract staff as well as a HQ team in...trained and capable individual to serve the Program Manager, Claims and Benefits Processing, Army Human Resources Command (AHRC),… more
- MetroLink (Los Angeles, CA)
- …development, scheduling, cost forecasting, risk management, and project closeouts. + Review project authorizations, including contract task orders, work orders ... and meets goals. TO APPLY: This is a continuous recruitment, with the review of applications beginning September 25, 2024 . Interested applicants are encouraged to… more
- US Tech Solutions (Columbia, SC)
- …Abilities: Working knowledge of spreadsheet, database software. Knowledge of contract language and application. Thorough knowledge/understanding of claims /coding ... sets/qualities: Must have at least 2 years hospital experience, any other utilization review experience is great, different areas of work is always a plus, must… more
- US Tech Solutions (Columbia, SC)
- …Abilities: Working knowledge of spreadsheet, database software. Knowledge of contract language and application. Thorough knowledge/understanding of claims /coding ... health management program interventions. + Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, monitor,… more
- ManpowerGroup (Columbia, SC)
- **Title: Coordinator, Managed Care I** **Location: Columbia SC** **Duration: 06 Month's Contract ** **Pay Range $25.00 to $31.00/hr.** We are looking for a ... health management program interventions. + Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, monitor,… more
- University of Utah Health (Salt Lake City, UT)
- …**Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + Performs contract compliance on outstanding claims ... + Ensures appropriateness of patient responsibility, as assigned by payer/ contract /benefit. + Resolves clinical and/or authorization denials through CARC analysis… more
- KPMG (Columbus, OH)
- …the contract management process, escalating to leadership when necessary; review client redlines and client terms for specific contracts by leveraging playbooks, ... and when required, escalate clauses for review to Subject Matter Experts, Risk Management, Independence, and...advisor to engagement teams and business leadership; able to advocate for leading contract lifecycle management practices,… more
- The Cigna Group (Phoenix, AZ)
- …a matrix organization + Deep familiarity with health insurance data, including contract structure and methodologies, claims , eligibility, provider and benefit ... enable decision making. + Use appropriate tools to transform, clean up, and review data. Analyze data to clearly outline findings, derive accurate results and… more
- MTA (New York, NY)
- …discuss contract grievance and employee discipline appeals; perform analytical review of claims , grievances, and discipline transcripts; prepare substantive ... agreements. + Provide prompt and accurate response to labor contract questions or concerns raised by operating department managers...Draft legal briefs and serve as the MNR management advocate at final and binding arbitration sanctioned by the… more
- Ardmore Roderick (Memphis, TN)
- …of contract change modifications and potential claim settlements. . Review and prepare written evaluations of contractor or consultant schedules. This includes ... Whether among our team or within the community, we advocate for inclusion and equality. . Innovation - We...cost control, ensuring projects stay within budget constraints. . Review specifications and calculate takeoffs from plans to determine… more
- The Cigna Group (Bloomfield, CT)
- …and organizational skills; effectively manage competing priorities and multiple deadlines. + Review , research and understand how request for plan services and ... claims submitted by consumers (members) and physicians/providers was processed...Identify and obtain all additional information (relevant medical records, contract language and process/procedures) needed to make an appropriate… more
- Robert Half Legal (Hyattsville, MD)
- …and manage client information * Employ Adobe Acrobat for document management and review * Utilize skills in civil litigation and personal injury litigation to ... advocate for clients * Manage claim administration processes to ensure all client claims are handled in a timely manner. For immediate and confidential… more
- The Cigna Group (Houston, TX)
- …as primary contact for providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. ... Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery + Prepare materials and participate in monthly… more
- The Cigna Group (Huntsville, AL)
- …as primary contact for providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. ... + Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery. + Assist in the STARS and clinical metrics data… more