- Health Plans, Inc. (Dallas, TX)
- …care. Role and Responsibilities This role will be responsible for claims administration, roster management, and appeal resolution within the Network Operations ... Department. + Maintain and review all inbound claims for network and pricing accuracy. + Implement Quality Assurance measures to ensure contract configuration… more
- Medical Mutual of Ohio (OH)
- …Organizes and performs analytical review of opportunities with provider networks. Performs claims repricing , discount analyses, etc. to support group sales ... **_This is a remote opportunity. Note, quarterly/ad-hoc/situational on-site requirement in Brooklyn,...Assists contracting in building tools that model rate. Performs claims repricing , discount analyses, etc. to support… more