- Evolent (Juneau, AK)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...our specialty programs and administrative platform. **Role Overview** The Associate Director role on Client Analytics will support both… more
- Travelers Insurance Company (Juneau, AK)
- **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our ... Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of claims and claim litigation to achieve superior customer service and to… more
- Walgreens (Soldotna, AK)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Cherry Bekaert (Juneau, AK)
- **Description** **Summary of Responsibilities:** The Senior Associate will work closely with the Cherry Bekaert FAO (Finance & Accounting Outsourcing) team, ... our clients in the insurance, service and related industries. The Sr. Associate will also assist in an administrative project management capacity, spearheading… more
- Highmark Health (Juneau, AK)
- …is responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of claim charges. The incumbent ... services and charges; will monitor internal referrals from sources such as claims , customer service, Medicare C&D Compliance, and Fraud Hotlines; will alert… more
- WESCO (Anchorage, AK)
- As a Administrator - Customer Care , you will be responsible for completing administrative daily tasks for assigned locations in accordance with established levels of ... KPI data used for process improvement. + Assists Customer Care Manager in development and training of employees. +...and training of employees. + Researches tax and freight claims and runs credit memo when appropriate. + Works… more
- Humana (Juneau, AK)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Juneau, AK)
- …this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus ... and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and… more
- Otsuka America Pharmaceutical Inc. (Juneau, AK)
- …Specialty Medicine products at different stages of development for a global health- care market. The specific duties assigned to the Director, Global Clinical ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director and 6-9...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Juneau, AK)
- …Specialty Medicine products at different stages of development for a global health- care market. The duties assigned to the Director, Global Clinical Development ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director is typically...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Humana (Juneau, AK)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5 years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
- Humana (Juneau, AK)
- …and/or other end compliant inquiries. + Has 6-7 direct reports including Associate Directors, Managers, and Senior Professionals + Provides strategic direction and ... operational efficiencies + Collaborates with upstream business partners such as Claims , Clinical Guidance, and the Provider Network to identify opportunities and… more
- Evolent (Juneau, AK)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...development efforts. **What You Will Be Doing:** + Analyze claims and authorization data to identify trends, calculate cost… more
- Humana (Juneau, AK)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Humana (Juneau, AK)
- …to identify opportunities and develop clinical solutions that aim at providing high-value care and addressing unmet needs for members with chronic conditions. We are ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- CenterWell (Juneau, AK)
- …us put health first** As a Sr. Business Intelligence Engineer for CenterWell Primary Care , you can directly impact patient care and outcomes through your work. ... your technical skills while also contributing to a larger mission of enhancing patient care and health outcomes. It's not just about numbers and datasets; it's about… more
- Humana (Juneau, AK)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Juneau, AK)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Juneau, AK)
- …populations served in target growth markets. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions for key ... member, products and benefits, and health plan administration portfolios (provider, claims , etc.), with areas of focus including Enrollment, Member Experience,… more
- CenterWell (Juneau, AK)
- …Contracting Professional ensures contract compliance and performs analysis regarding pharmacy claims and network composition to identify contracting needs to provide ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more