- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** The Claims Review Representative 3 makes appropriate claim decision based on strong knowledge of ... claims procedures, contract provisions, and state and federal legislation....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Banner Health (AZ)
- …the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better ... optimal reimbursement with focus across all continuums of patient care . Revenue Integrity in an integral part of the...Integrity Analyst you will work with a variety of claims , correcting coding or charging errors that may prevent… more
- Humana (Phoenix, AZ)
- …to drive improvements in quality and/or reductions in total cost of care + Scorecard creation and reconciliation of provider performance based on contractual ... Qualifications:** + Bachelor's Degree + 3-5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care +… more
- Banner Health (AZ)
- …a difference in the lives of others." Looking for a motivated, experienced ** Associate Manager, ** **Physi** **cian Practice Coding** to join our talented team ... CGSC is a PLUS.** **This position will be the Associate Manager over coders and include concurrent HCC audits...and education to fellow coders.** **This is a fully remote position and available if you live in the… more
- Marriott (Phoenix, AZ)
- …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
- Centene Corporation (Phoenix, AZ)
- …or equivalent. Associate 's degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem ... 8am-5pm AZ Time.** **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal… more
- Banner Health (AZ)
- …the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better ... optimal reimbursement with focus across all continuums of patient care . Revenue Integrity in an integral part of the...- 7 pm** **AZ Time** **This can be a remote position if you live in the following state(s)… more
- Humana (Phoenix, AZ)
- …team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical ... depth of knowledge of administrative processes and organizational knowledge. **This is a remote position from anywhere in the US.** **What Humana Offers** We are… more
- Humana (Phoenix, AZ)
- …This role will complete quality reviews on the coding processes within the Claims Cost Management organization, focusing on the review types of APC, E&M, SCR, ... impact** This role will complete quality reviews on the coding processes within the Claims Cost Management organization, focusing on the review types of APC and the… more
- Humana (Phoenix, AZ)
- …to business & customers we serve using the latest in software technology? Our claims services team is best positioned in building modernized claims eco systems ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
- Humana (Phoenix, AZ)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Phoenix, AZ)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
- Humana (Phoenix, AZ)
- …volumes of data + Good understanding of healthcare data eg, member, provider, claims and clinical data + Experience and understanding of data governance practices ... **Location/Work Style:** Hybrid Office in Louisville, KY is preferred but open to Remote US as well **Why Humana?** At Humana, we know your well-being is… more