- Novant Health (Winston Salem, NC)
- Job Summary The Claims Manager is responsible for analyzing, negotiating and resolving claims , including professional and general liability, for all Novant ... and staff. + Coordinates investigation and analysis of incidents and legal claims filed against Novant physicians and entities. Assist and supervises legal… more
- Elevance Health (Winston Salem, NC)
- **Telephonic Nurse Case Manager II ** **Hours: Monday - Friday 9 - 5:30 pm EST, plus 3 times a month 11:30 - 8 pm EST.** **Location:** This role enables ... states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible for care management within the scope… more
- Elevance Health (Durham, NC)
- **Performance Quality Analyst II ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while ... granted as required by law. The **Performance Quality Analyst II ** is responsible for driving service quality excellence by...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Elevance Health (Durham, NC)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II ** is responsible for identifying issues and/or entities that may… more
- Elevance Health (Durham, NC)
- **Utilization Management Representative II ** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... shift between 8 am - 8 pm EST. The **Utilization Management Representative II ** is responsible for managing incoming calls, including triage, opening of cases and… more
- UIC Government Services and the Bowhead Family of Companies (Stumpy Point, NC)
- **Overview** Electronic Warfare Range Site Manager (PTR-2024-21974): Bowhead seeks to network withElectronic Warfare Range Site Managers for an upcoming/potential ... problem areas. After scheduled hours of operations, the site manager is required to be available within 2 hours,...5 years + Dept of Labor Electronic Technician Level II or AF 5-level equivalent experience + Expert knowledge… more
- Mass Markets (NC)
- …of the position + Must be willing to submit up to a LEVEL II background and/or security investigation with a fingerprint. Job offers are contingent on ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- Mass Markets (NC)
- …of the position + Must be willing to submit up to a LEVEL II background and/or security investigation with a fingerprint. Job offers are contingent on ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- HNTB (Raleigh, NC)
- …RFP development to aid in pursuit development. + Provides schedule support for claims analysis (eg, using contractor claims , delay cost estimates, time impacts, ... sequencing into the schedule. + Leads the planning effort alongside Project Manager , collaborates and makes recommendations to project management team in planning… more
- Highmark Health (Raleigh, NC)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... + Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and...related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges… more