- Santander US (East Providence, RI)
- Director , Claims & Fraud Operations East Providence, United States of America USA Job Family Description: Responsible for the day-to-day operations ... them into operational implications for the company. The Director of Claims & Fraud Operations will lead a fraud operations support function with… more
- Wells Fargo (Chandler, AZ)
- **About this role:** Wells Fargo is seeking a ** Fraud & Claims Operations Director ** in the Claims Assistance Center as part of the Fraud & ... . Wells Fargo Consumer Operations is seeking a Fraud & Claims Operations Director to report to the Head of Claims and Recovery.… more
- State of Massachusetts (Boston, MA)
- The Deputy Program Integrity Director is a policy, people and operational leader within the Program Integrity Unit of MassHealth. The Program Integrity Unit is a ... of MassHealth members. The team is led by the Director of Program Integrity, who reports to the Deputy... is responsible for leading MassHealth's efforts to control fraud , waste and abuse ("FWA") across the agency's programs.… more
- Alight (IN)
- …. Strategic Leadership | Direct and oversee the quality and training function for claims operations | Work with the Operations Leader in establishing ... regulatory changes. | Drive innovation and adapt best practices to improve claims operations . Qualifications: . **Education**: - Masters/Bachelor's degree in a… more
- University of Washington (Seattle, WA)
- …of Bioengineering (https://bioe.uw.edu/) is looking for an outstanding leader as its Director . UW Bioengineering is a vibrant community driving advances in health ... reports to the Department Chair and Associate Dean of Administration and Operations and serves as the business manager/senior administrative and managerial support… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role The Director of Applications Support has responsibility for strategic development and execution of a quality program for system configuration and ... for more standardized configuration across clients. + Collaborate with and support Operations as needed to ensure the efficient processing and optimal performance. +… more
- Sacramento County (Sacramento, CA)
- …7/19/24 (Final) Under direction, the Workers' Compensation Examiner performs specialized claims service in the administration of the County's self-insured Workers' ... relating to workers' compensation matters + Methods of evaluating workers' compensation claims and computing benefits Ability to + Read, interpret, and apply… more
- UPMC (Pittsburgh, PA)
- …and other coding activities, including: Completion of special projects including claims and/or coding related audit support. Communicate effectively with Risk ... assignment and accurate reimbursement. Clinical guidance and support to Fraud and Abuse department. Clinical review for high dollar... and Abuse department. Clinical review for high dollar claims and other clinical guidance as needed for Quality… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- …of the senior management team, the Division Manager will collaborate with the Claims Administration Division Manager, the Deputy Director , and the Director ... software system. The Division Manager will assist the PFML Director in financial reporting related to the PFML trust...performance and examine relevant data and information to improve operations and best practices. + Contributes to the initial… more
- Beth Israel Lahey Health (Burlington, MA)
- …Analyst serves as a primary point of contact for Billing Director , Service Line Directors, Managers, Finance Directors, clinical support staff, Physicians, ... limited to, payer policies. 11. Responsible to advise and assist with revenue operations as they relate to Epic build decisions, in-depth analysis of denials,… more
- Beth Israel Lahey Health (Burlington, MA)
- …making a difference in people's lives.** Under the managerial oversight of the Director , Senior Manager, or Manager of Revenue Cycle, the Revenue Cycle Analyst ... and Revenue Cycle Leadership. 2. Responsible to advise and assist with revenue operations as they relate to Epic build decisions, in-depth analysis of denials,… more
- City of New York (New York, NY)
- …BOOKEEPER CIVIL SERVICE TITLE The Office of Child Support Services, Fiscal Operations which handles all fiscal related activities is responsible for ensuring that ... for ensuring the fiscal integrity of OCSE by preventing fraud throughout the collection and disbursement process. It prepares...for accuracy and completeness. Responsible for the examination of claims and vouchers as well as all valid … more
- Bausch Health (Bridgewater, NJ)
- …people's lives with our health care products. Reporting to the Senior Director , Finance (Revenue & GTN Accounting), the Senior Manager, Finance Commercial Contracts ... Medicare Part D contracts and will oversee the daily operations of the contract management function. This individual will...**Areas of responsibility -** + Review and approve rebate claims data received for managed care contracts, Medicare Part… more
- FirstBank PR (Miami, FL)
- …special projects/investigation or any other matter as determined by BSA Manager and/or Operations Director Independence of Judgment : The degree of judgment is ... Unit Supervisor Job Summary : Responsible for all Bookkeeping/Deposit Operations requirements including formulating the proper procedures and guidelines to… more
- Baptist Memorial (Covington, TN)
- …available for each particular BSP patient scenario + Responsible for daily billing operations , such as submission of claims (electronic and paper), patient ... assistance for their prescriptions. The individual in this position supports the BSP Director , BSP Pharmacy Staff and Clinical Pharmacists to ensure that all duties… more