- Guardian Life (Richmond, VA)
- The **Group Life/Supplemental Health Claims Case Manager II ** is responsible for making timely and accurate decisions on assigned claims through ... decisions while providing superior customer service to all internal and external customers. The Claims Case Manager II administers claims within a… more
- Guardian Life (Richmond, VA)
- …share insights and learnings with claims colleagues. **Reporting Relationships:** As our Appeals Case Manager II , you will report to our Leader, Appeals ... Guardian is seeking individuals with Group Disability claims experience to join our dynamic Appeals Team. The Appeals Case Manager II (ACM 2) is… more
- Elevance Health (Norfolk, VA)
- **Nurse Case Manager II ** **Location: This is a virtual position.** **Hours: Monday** **- Friday 8:00am to 4:30pm EST and 2-3 late evening 11:30am to 8:00pm ... EST per month.** The **Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- US Tech Solutions (Chesapeake, VA)
- …all levels to enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face and telephonically assessing, ... and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case... claims to address potential impact on current case management and eligibility. Assessments include the member's level… more
- Highmark Health (Richmond, VA)
- …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...works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs… more