- AmeriHealth Caritas (Newtown Square, PA)
- ** Vice President Claim Payment Administration** Location: Newtown Square, PA Primary Job Function: Management ID**: 31453 Your career starts now. We are ... Vice President , Enterprise Operations, the Vice President , Claim Payment...of payment integrity requirements, state and federal claim payment regulations, claims … more
- Health Plans, Inc. (Westborough, MA)
- …the latest administrative and data-mining technology, and reinsurance (stop-loss) security. Summary: The Vice President of Claims Operations oversees the ... Claims , Technical Resource Unit, Reinsurance, Enrollment, Billing & Payment Configuration, and Cobra areas of the business. The... Configuration, and Cobra areas of the business. The Vice President of Claims Operations… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as an Assistant Vice President of Payer Engagement? At HCA Healthcare, you come first. HCA Healthcare ... a difference. We are looking for a dedicated Assistant Vice President of Payer Engagement like you...to oversee the strategic resolution and prevention of denials, payment discrepancies and other claims adjudication issues… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role The Vice President - ASG, reporting to the CIO, is a senior Information Technology leader with a proven track record of scoping, defining, ... which include but not limited to: + Core Healthcare Claims Processing Platform + Provider Credentialing Platform + Eligibility...not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our… more
- Somatus (Mclean, VA)
- …beneficial to the provider and Somatus while working within a specified budget. + Payment Integrity Product Areas- Clinical Claim Review, Payment Analytics, ... Fraud Capture and Utilization Review Product Management + Oversees new product development strategy and execution + Responsible for ensuring appropriate product roadmap and collateral documentation is available + Develops appropriate business cases to obtain… more
- Lyric (CT)
- …overall customer satisfaction and A+ likelihood to recommend in their October 2023 Payment Integrity and Accuracy Report. Discover more at Lyric.ai . **About this ... area . 10+ Years experience in healthcare with **specific focus on payer claims ** systems and products 10+ years of product development experience in agile… more
- Billings Clinic (Billings, MT)
- …any concerns they have in this regard with their immediate supervisor and/or the Vice President People Resources. All employees and job applicants will be ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Claims Specialist I - CBO (Full-time/Billings) CENTRAL BILLING OFFICE… more
- Humana (Columbus, OH)
- …organization capabilities interrelate across segments and/or enterprise wide. The Associate Vice President , Clinical Strategy will lead a multi-disciplinary team ... and will report directly to our Vice President , Clinical Strategy. This position can...incentives, contracting) and Clinical Operations (eg coverage policies, enforcement, claims payment ). It is expected that opportunities… more
- Covenant Health Inc. (Knoxville, TN)
- …in a timely and accurate manner.Reviewing billed claims for timely and accurate payment . Timely research and follow up of claim denials. Serve as a liaison ... for the department and the facilities, adhering to desired behaviors. + Assists Vice President , Director, Managers and Supervisors on activities and projects, as… more
- Colorado State University (Fort Collins, CO)
- …between student/parents and their insurance company to decipher contracting status and claim payment disputes. Our department follows the status of payments ... pre-billing edits on clinic visits to ensure that insurance claims are submitted with correct codes and that the...the University's Policy on Discrimination and Harassment is the Vice President for Equity, Equal Opportunity and… more
- Molina Healthcare (Escondido, CA)
- …outreach and resolving provider inquiries. * In conjunction with the Associate Vice President , Network Strategy & Services, develops health plan-specific ... development and the education of contracted network providers regarding plan procedures and claim payment policies. * Develops and implements tracking tools to… more
- Washington Metropolitan Area Transit Authority (Washington, DC)
- …procurement of materials, equipment and services in programmatic areas designated by the Vice President & Chief Procurement Officer (VP CPO). The incumbent has ... with regard to the contractor's proposal for contract closeouts, modifications, and claims , based on time and cost analyses, conferences, financial statements, audit… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Vice President , Quality & Controls Assurance reports to compliance leadership, and strategically and operationally ... leads various quality reviews of claims , Hierarchical Condition Categories (HCC) and clinical coding, call...and ensuring the reporting of relevant quality audit/review results, pre- payment and post- payment claim reviews,… more
- Covenant Health Inc. (Knoxville, TN)
- …meets other requests of the CMG Director of Revenue Cycle and Vice - President of Financial Services. Recruiter: Sarah Grey ||###@covhlth.com|| ### ... to the satisfaction of the CBO Operations Manager, Director of Revenue Cycle, and/or Vice - President of Financial Services. + Supports, models and adheres to the… more
- Travelers Insurance Company (St. Paul, MN)
- …$161,200.00 **Target Openings** 1 **What Is the Opportunity?** Reports to Assistant Vice President , Operations or Operations Director. Implements strategic and ... Develop and maintain effective relationships with internal resources (eg, Claim , Operations, etc.) to coordinate the delivery of all...+ Two years of experience in underwriting, service, sales, claims , and/or operations. **What Is in It for You?**… more
- Billings Clinic (Billings, MT)
- …any concerns they have in this regard with their immediate supervisor and/or the Vice President People Resources. All employees and job applicants will be ... with prescribed tablets/capsules, processing prescriptions and emergent prescriptions, adjudicating claims , performing point of sale functions, proper utilization of… more
- Prime Therapeutics (Columbus, OH)
- …methodology, investment portfolio selection and performance, and debt administration, and claim payment process, including applying regulatory requirements for ... perception and ability to adjust focus **Reporting Structure** + Reports to an Assistant Vice President in the in the Finance department Potential pay for this… more
- HCA Healthcare (Overland Park, KS)
- …to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing Executive If you find this opportunity ... the Business Office Manager/Business Office Supervisor, you will obtain payment from third party payers and self-pay accounts to...work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims… more
- State of Massachusetts (Haverhill, MA)
- …require a high degree of confidentiality. The HR Generalist will report to the Vice President of Human Resources or designee. *RESPONSIBILITIES: * * Conducts ... mass retro payment calculations. * Ability to process Worker's Compensation claims and provide any necessary follow-up. * Serve on college committees as… more
- Veterans Inc. (Shrewsbury, MA)
- …to join our behavioral health programming. Under the general direction of the Vice President of Finance, Development and Administration, the Business Manager ... to processing charges for services. Will respond to any claim denials and correct the error for resubmission for...as required + Point of contact for questions about payment transactions. WHAT YOU MUST HAVE: + Minimum of… more