- LA Care Health Plan (Los Angeles, CA)
- Manager , Claims Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11625 ... net required to achieve that purpose. Job Summary The Manager , Claims directs the efforts of others...goals of the company. The Manager must provide mentoring to supervisors and Claims department… more
- USAA (Colorado Springs, CO)
- …6 months time in role. **What sets you apart:** + Current experience as a Claims Manager /Supervisor. + 2+ years of experience handling total loss claims . ... members. We believe in our core values of honesty, integrity , loyalty and service. They're what guides everything we...**This posting is for multiple opportunities within the Auto Claims organization. This manager may lead a… more
- USAA (Phoenix, AZ)
- …time in role. **What sets you apart:** + Current leadership experience as an Auto Claims Manager or Supervisor + 5+ years handling 3rd party auto moderately ... members. We believe in our core values of honesty, integrity , loyalty and service. They're what guides everything we...makes us so special! **The Opportunity** As a dedicated Manager , Claims Operations, you will lead a… more
- USAA (San Antonio, TX)
- …Injury or Litigation team + Experience applying advanced knowledge to partner with Claims Operations and provide guidance for complex claim settlements that ... members. We believe in our core values of honesty, integrity , loyalty and service. They're what guides everything we...**The Opportunity** We are seeking dedicated Managers for our Claims Auto Bodily Injury Litigation area. This role will… more
- Providence (MT)
- …we must empower them.** **Providence is calling a Sr. Medical Malpractice Claims Manager - Professional Liability who will:** **Investigate, Evaluate, and ... take proper steps to pay vendors + Inform Senior Manager Operations of large or complex claims ...to assist the SVP Chief Risk Officer and Senior Manager Operations as needed ** Provide Input to… more
- USAA (New York, NY)
- …makes us so special! **The Opportunity** **The Opportunity** **We are seeking a dedicated Manager Claims Operations - Field APD.** Manages and is accountable for ... members. We believe in our core values of honesty, integrity , loyalty and service. They're what guides everything we...auto, property, and other claims operations member service employees who are responsible for… more
- CRC Insurance Services, Inc. (Flower Mound, TX)
- …goals. 4. Review, analyze, track and take appropriate action on losses in order to provide account loss ratios and claims history to senior management. 5. Train ... for overseeing, managing and supporting all activities of the claims employees and operations of the department. **ESSENTIAL DUTIES...thrive in a fast-paced, collaborative environment. If you value integrity and are driven to succeed, CRC Group is… more
- Trinity Health (Columbus, OH)
- …your own in Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** The Manager Claims Operations manages the daily operations for claims ... of professional roles including information technology, financial analysis, audit, provider relations and more. We know that exceptional patient...as the main point of contact and as the Claims subject matter expert (SME) for internal and external… more
- City of New York (New York, NY)
- …Revenue, and Enforcement Administration (IREA) is responsible for supporting the integrity of social services programs administered by the New York City ... Office of Revenue that houses SNAP-CR. They establish SNAP claims for the agency according to the Federal SNAP...Principal Administrative Associate III to function as an Assistant Manager who will: - Directly and indirectly supervise staff… more
- LA Care Health Plan (Los Angeles, CA)
- …purpose. Job Summary The Claims Quality Auditor II works closely with the Claims Quality Auditing Manager . The Claims Quality Auditor II maintains ... processes. This position serves as a liaison between partnering departments ie Payment Integrity and Claims Compliance. This position works to ensure claims … more
- USAA (Phoenix, AZ)
- …we need the right people. We're looking for those who share our values of honesty, integrity , loyalty and service. Because what we do is just as important as how we ... what makes us so special! It is all about learning and growing. Our Customer Service Claims Representative role may be a new career for you. There's a lot to learn,… more
- Guidehouse (Lewisville, TX)
- …billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the meeting of both ... regarding this opening, you may contact Chris Rivera (Recruiting Manager ) at ###_** **Essential Job Functions** + Hospital Billing...Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides… more
- University of Washington (Seattle, WA)
- …resolves problems and disputes and/or recommends administrative course of action to the Claims , Payment & Credit Manager with the development and implementation ... Practice Plan Services (FPPS)** has an outstanding opportunity for a **full-time, day shift, CLAIMS SUPERVISOR.** **WORK SCHEDULE** + 40 hours per week + Day Shift +… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …implementations team. FEP is BCBSMA's single largest account Position Summary: The RN Clinical Provider Post Service Review Manager , led by a Registered Nurse, ... perform claim adjustments in a dual system environment. This manager also has direct oversight to a team of...MA required. Bachelor's degree preferred + Experience with the Provider appeals process required; coding and claims … more
- Guidehouse (Lewisville, TX)
- …from home._** **_Questions regarding this position, you may contact Chris Rivera ( Manager , Talent Acquisition) at ###._** The Patient Account Representative has an ... and reports findings to supervisor + Bills or re-bills claims as necessary + Ensures the client follows all.../ or plan changes as appropriate to ensure the integrity of the insurance master is maintained + Updates… more
- AmeriHealth Caritas (Charleston, SC)
- ** Manager , Provider Network Management - Remote South Carolina only** Location: Charleston, SC Primary Job Function: Medical Management ID**: 34447 Your career ... contracts. + Responsible for implementing electronic strategies for the provider network, including increasing electronic claims submission and implementing… more
- The Cigna Group (Nashville, TN)
- **Summary** The Data Governance & Ownership (DG&O) Senior Manager will work with the Provider Data Quality & Accuracy (PDQA) Director to establish the framework ... Monitoring of provider data quality and accuracy leading to CMS compliant provider directories and improved claims auto-adjudication. + Work within the Data… more
- Blue Cross and Blue Shield of Louisiana (Monroe, LA)
- …that all provider information is entered accurately, timely, and efficiently to provide for proper claims adjudication, provider directory accuracy, and ... level standards, compliance, and regulatory requirements. + Supports the integrity of the provider data for all...requirements. + Supports the integrity of the provider data for all participating and non-participating providers by… more
- Elevance Health (Louisville, KY)
- **Account Service Manager Sr.** **Location:** This will be a Hybrid position reporting to the office a minimum of one day a week. The ideal candidate will live ... KY or Waukesha, WI. **Schedule:** 8:00 AM-5:00 PM Monday - Friday _Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon… more
- Elevance Health (Columbus, OH)
- **Clinical Provider Auditor I** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ... within 50 miles of one of our Elevance Health PulsePoint locations._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon… more