• Operations Analyst III - Claims

    Trustmark (Baton Rouge, LA)
    …to work on-site at our office in Lake Forest, IL for 3 days. Fully remote candidates are also welcome to apply.* We are seeking a detail-oriented and analytical ... to join our team, specializing in the Voluntary Benefits Claims area. The individual in this role: Serves as...FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up Care for Children, Adults and Elders and many health… more
    Trustmark (05/22/24)
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  • Medicare Health Plan Operations Specialist…

    Prime Therapeutics (Baton Rouge, LA)
    …we make. **Job Posting Title** Medicare Health Plan Operations Specialist - Remote **Job Description** The Associate Functional Business Consultant serves as ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or area related to the department with… more
    Prime Therapeutics (05/29/24)
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  • Care Management Associate

    CVS Health (Baton Rouge, LA)
    …our people to transform health care . Position Summary: The Care Management Associate role is a full time remote telework position. Care Management ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...+ May assist in the research and resolution of claims payment issues. Supports the administration of the hospital… more
    CVS Health (05/04/24)
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  • Case Manager RN ( Remote )

    CVS Health (Baton Rouge, LA)
    …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. This is a full-time telework position.… more
    CVS Health (05/30/24)
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  • Senior Patient Accounts Representative Collections…

    Fresenius Medical Center (Metairie, LA)
    …DUTIES AND RESPONSIBILITIES: + Under limited supervision, identify and resolve complex claims and discrepancies. + Generate and analyze diverse reports and work ... lift and/or move up to 50 pounds. EDUCATION: High School Diploma required; Associate 's Degree desirable EXPERIENCE AND REQUIRED SKILLS: + 2 - 4 years' related… more
    Fresenius Medical Center (06/01/24)
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  • Staff Professional-Risk Mgmt

    Marriott (Baton Rouge, LA)
    …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
    Marriott (05/12/24)
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  • Behavioral Economics Research Scientist 2

    Humana (Baton Rouge, LA)
    …first** Humana's Behavioral Economics Team is seeking a Research Scientist ( Remote ) to support our work developing measurement strategies across the enterprise. ... rigorous test & learn approaches to answer high-priority business questions. **Location:** remote In this multi-disciplinary team, you will have the opportunity to… more
    Humana (05/30/24)
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  • Analyst Medical / Financial Risk Evaluation

    Humana (Baton Rouge, LA)
    …more years of experience with CMS and/or AHCA compliance + 2 or more years Claims experience + 2 or more years Audit and/or Financial Recovery experience + SQL ... structure and design **Preferred Qualifications** + Direct experience working with Medicare claims + Working knowledge of CPT, ICD10 and HCPC + Provider contract… more
    Humana (05/30/24)
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  • Code Edit Disputes Team Medical Coding Coordinator

    Humana (Baton Rouge, LA)
    …team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical ... depth of knowledge of administrative processes and organizational knowledge. **This is a remote position from anywhere in the US.** **What Humana Offers** We are… more
    Humana (05/17/24)
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  • Oncology Practice Enablement Clinician

    Elevance Health (Metairie, LA)
    …Practice Enablement Clinician** **Location** : This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from one ... key strategic solutions that involve practice collaboration and enablement to improve member care quality and value. Serves as a strategic solution lead for Oncology… more
    Elevance Health (05/18/24)
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  • Senior Hierarchical Condition Category (HCC)…

    Highmark Health (Baton Rouge, LA)
    …risk-adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA) through Hierarchical Condition Category (HCC) coding, medical coding, ... Risk Adjustment Data Validation (RADV) audit coding review, including analysis of claims data to ensure chart acquisition is complete and documentation is… more
    Highmark Health (05/31/24)
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  • Senior Disability Underwriter

    Humana (Baton Rouge, LA)
    …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
    Humana (05/17/24)
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  • Lead Solutions Architect

    Humana (Metairie, LA)
    …volumes of data + Good understanding of healthcare data eg, member, provider, claims and clinical data + Experience and understanding of data governance practices ... **Location/Work Style:** Hybrid Office in Louisville, KY is preferred but open to Remote US as well **Why Humana?** At Humana, we know your well-being is… more
    Humana (05/05/24)
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