- Lincoln Financial (Harrisburg, PA)
- …**Requisition #:** 74647 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... coaching and development to perform in this fast-paced environment. As a Claims Customer Care Associate , you will be responsible for answering claimants… more
- Humana (Harrisburg, PA)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs ... of decisions to internal associates, and possible participation in care management. May occasionally participate in discussions with external physicians… more
- CVS Health (Harrisburg, PA)
- …PM EST (Regular Shift will be different once training is completed.) As a Care Management Associate you will be supporting comprehensive coordination of medical ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Evolent (Harrisburg, PA)
- …a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to ... a mission with a company behind it. **What You'll Be Doing:** ** Associate Director, Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent… more
- Evolent (Harrisburg, PA)
- …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 (Harrisburg, PA)
- **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
- Walmart (Mechanicsburg, PA)
- …are aligned with company and regulatory standards for prescriptions and claims doctor and optician certificationslicensure and associate training Guides ... your chance to be part of it. A Walmart Associate Optometrist is the clinical partner to the Vision...** How Youll Make An Impact Provide evidencebased vision care to ensure patients health and wellbeing by recommending… more
- Walmart (Harrisburg, PA)
- …Floor in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing hand held technology to make immediate business decisions… more
- Intermountain Health (Harrisburg, PA)
- **Job Description:** Provides extraordinary care to our customers through friendly, courteous, and professional service through a broad understanding of account ... + Perform other duties as assigned **Skills** + Insurance Claims + Medical Billing + Explanation of Benefits (EOB)...hourly rate dependent upon experience. $18.81 - $27.45 We care about your well-being - mind, body, and spirit… more
- Walmart (Harrisburg, PA)
- …thinking You will make an impact by: * Ensuring high-quality products are taken care of and available for our members * Ensuring shelves are clean, maintaining ... area in accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking merchandise; setting up,… more
- Walmart (Harrisburg, PA)
- …appropriately merchandising and completing required documentation Tracks and processes claims by returning damaged goods handling liquidation merchandise maintaining ... company-paid life insurance **-Paid time off benefits** include PTO, parental leave, family care leave, bereavement, jury duty, and voting. You will also receive PTO… more
- Sedgwick (Harrisburg, PA)
- …claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care ; transfers payment allocations; and runs manual ... required. Associate degree preferred. **Experience** Two (2) years of claims management or insurance experience or equivalent combination of education and… more
- Humana (Harrisburg, PA)
- …community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims ... Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to stakeholders. The… more
- Humana (Harrisburg, PA)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters… more
- Humana (Harrisburg, PA)
- …achieving operational and compliance key performance indicators. In addition, the associate will participate in cross functional teams and support analyzing business ... an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and… more
- CenterWell (Harrisburg, PA)
- …of the Pharmacy Analytics division, with responsibilities that include working with pharmacy claims data. The team to which this position reports is dedicated to ... PowerBI + Experience in Databricks is preferred + Experience in analyzing pharmacy claims data Travel: While this is a remote position, occasional travel to Humana's… more
- Humana (Harrisburg, PA)
- …have expertise in conducting retrospective observational studies using administrative claims data using a collaborative approach across multiple stakeholders. Humana ... + An understanding of research methodology and the managed care arena, and how it applies to health outcomes...with cloud base analytics platforms + Experience with clinical, claims , pharmacy or other healthcare data. + Strategic thinking… more
- CVS Health (Harrisburg, PA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... recommend solutions. **Required Qualifications** + 1 plus years knowledge of plan documents, claims research, letter writing. + 1 plus years working with appeals, … more
- Highmark Health (Harrisburg, PA)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
- Humana (Harrisburg, PA)
- …health first** **Requires a strong foundation in COBOL mainframe development ** The Claims Adjudication System (CAS) team at Humana is essential in delivering core ... services through effective claims processing and management solutions. This position involves coding software applications based on business requirements and… more