- Serco (Washington, DC)
- …characteristics. Click here to apply now (https://careers-sercous.icims.com/jobs/64176/ health - policy - medical - claims ... Description** Serco is seekinga motivated Assistant Program Director for Medical Claims Review to join our talented...claims processing review for the Medicaid and Children's Health Insurance Program. The position also is responsible for… more
- Guardian Life (Washington, DC)
- …Meet productivity requirements as established by department for handling Supplemental Health Claims . Leadership Behaviors + Demonstrates intellectual curiosity. ... have + Experience of 3 plus years processing Supplemental Health claims . (Accident, Critical Illness, Cancer and...flexible, and inclusive benefits and resources to our colleagues. ** Health Care** + Choice of [high deductible/copay] medical… more
- Travelers Insurance Company (Chantilly, VA)
- …input and shares ideas. + Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. ... resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- HomeSafe Alliance (Washington, DC)
- **Title:** Claims Adjuster (SCA) HHG/Military Move **HomeSafe Alliance** is the single global household goods movement manager of over 300,000 Military Household ... an SCA position** . **Position Summary** : **HomeSafe Alliance** is seeking experienced Claims Adjustors with experience in HHG/Military Move to process and settle … more
- Sedgwick (Washington, DC)
- …regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Auto **PRIMARY PURPOSE** : To analyze...are properly documented and correctly coded based on the policy . + Develops and maintains action plans to ensure… more
- Sedgwick (Washington, DC)
- …regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Auto Claims Manager **PRIMARY PURPOSE** : To manage the technical and operational… more
- Serco (Washington, DC)
- **Position Description** Serco is seekinga motivated Policy Specialist for Medical Claims Review to join our talented and fast-paced Public Sector Solutions ... national reporting; and development of corrective actions based on review findings. The Policy Specialist for Medical Claims Review position would support… more
- Serco (Washington, DC)
- …unique combination of strong program management experience and subject matter expertise in medical records review and claims processing review for the Medicaid ... critical issues and program improvements to coordinate and optimize multiple aspects medical and claims review operations. **_Hybrid or full-time remote work.… more
- Amazon (Arlington, VA)
- …and tools that help them succeed, and enforce our policies when necessary. This Policy Manager will support the work we're doing to guide our buyers to perfect ... role will support the product and program teams working on Amazon's A-to-z Claims Guarantee, Seller Profile Page, Seller Reviews, and Order Performance. An ideal… more
- Drug Enforcement Administration (Arlington, VA)
- …practice; recovery support; peer support; case management or coordination; or mental health /behavioral health policy . Developing strategies and plans for ... serving as an expert on public/mental health administration or mental health /behavioral health policy ; 2) conducting complex scientific investigations… more
- Serco (Washington, DC)
- **Position Description** Serco is seekingseveral motivated Eligibility Policy Analysts to join our talented and fast-paced Public Sector Solutions team in supporting ... Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as required by the… more
- Serco (Washington, DC)
- …matter expertise in medical records review of the Medicaid and Children's Health Insurance Program claims . The position is responsible for the advising on ... insurance industry, a utilization review firm, or another health care claims processing organization involving medical and coding reviews of a variety of… more
- Highmark Health (Washington, DC)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... work. + Calculate rates, employ different financial arrangements, interpret pricing policy and adapt to unusual situations. + Identify questionable claim patterns… more
- Highmark Health (Washington, DC)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... staff. + Calculate rates, employs different financial arrangements, interprets pricing policy and adapts to unusual situations. + Identify questionable claim… more
- Serco (Washington, DC)
- **Position Description** Serco is seekinga motivated Medical Records Manager for Medical Claims Review to join our talented and fast-paced Public Sector ... in direct communication with the Assistant Program Director for Medical Claims Review in managing medical... medical records and the electronic transmission of medical records; + Certification as a Registered Health… more
- Serco (Washington, DC)
- …A minimum of three (3) years of experience in a supervisory or managerial role in medical claims or clinical data management; + A minimum of five (5) years ... enrollment. + Knowledge and expertise in working with states' claims processing systems (including MMIS), payment policy ,... insurance industry, a utilization review firm, or another health care claims processing organization. + An… more
- Serco (Washington, DC)
- …+ Be in direct communication with the Program Director, Assistant Program Director for Medical Claims Review, Data Processing Reviewers, and CMS PERM staff, as ... program, particularly the coverage, conditions of payment, and state-specific policy requirements for health care coverage and...three (3) years of supervisory or managerial experience in medical claims or clinical data management; +… more
- Travelers Insurance Company (Chantilly, VA)
- … with lost time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a ... Medical Case Manager. Independently handles assigned claims ...+ Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical … more
- Serco (Washington, DC)
- …and/or CHIP program, particularly the coverage, conditions of payment, and state-specific policy requirements for health care coverage and payment; + Experience ... contract which includes collection of state eligibility policies and medical records; eligibility reviews, medical reviews, and... insurance industry, a utilization review firm, or another health care claims processing organization; + An… more
- Trinity Health (Aspen Hill, MD)
- …Required:** High school graduate possessing two () years experience in accounting and medical claims management, preferably in a hospital or physician's office ... hospitals limited community benefit resources by implementing the financial assistance policy with fairness and accuracy. Resolve patient's billing concerns via the… more