• Claims Research & Resolution Representative

    Humana (Jackson, MS)
    …our caring community and help us put health first** Humana/iCare is seeking a Claims Research and Resolution Representative 2 to join our growing team. This position ... is responsible for researching, examining and responding to claims processing issues in a timely manner, including provider...Information** + **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an… more
    Humana (05/16/24)
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  • Sr. Value-Based Programs Professional…

    Humana (Jackson, MS)
    …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
    Humana (04/24/24)
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  • Staff Professional-Risk Mgmt

    Marriott (Jackson, MS)
    …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
    Marriott (05/12/24)
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  • Code Edit Disputes Team Medical Coding Coordinator

    Humana (Jackson, MS)
    …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 (05/17/24)
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  • Lead Software Engineer

    Humana (Jackson, MS)
    …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 (05/08/24)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Jackson, MS)
    …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 (05/02/24)
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  • Senior Disability Underwriter

    Humana (Jackson, MS)
    …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 (05/17/24)
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  • Lead Solutions Architect

    Humana (Ridgeland, MS)
    …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
    Humana (05/05/24)
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