- LA Care Health Plan (Los Angeles, CA)
- Manager , Claims Data Operations...Required: At least 6-8 years of experience working with healthcare data . Minimum of 3-5 years of ... net required to achieve that purpose. Job Summary The Manager of Claims Data Operations...a healthcare setting Prior experience working with healthcare data from a managed care environment.… more
- Trinity Health (Livonia, MI)
- …facilitations, mediation, and trial. Provides status reports for open and closed claims to facility Risk Manager , facility administrators, committees and others ... Liability (HPL), General Liability (GL) and Employment Practices Liability (EPL) claims and litigation, and co-manages uninsured litigation across the system.… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** Minimal data entry from non-scanned claims into GE according to established procedures. ... **Required Qualifications** + 1 Year previous claims experience in an HMO or indemnity insurance setting (HMO preferred) or related experience **Essential… more
- Providence (Renton, WA)
- …organization + Maintain up-to-date and accurate claim files, including summaries, action plans, and claims status in the claims data management software + ... retain the best people, we must empower them._** **Providence is calling a Senior Claims Insurance Manager - Medical Professional Liability Claims Handler… more
- Elevance Health (Woburn, MA)
- …card, send you a check, or ask you for payment as part of consideration for employment. ** Claims Manager II** + Job Family: CLM > Claims Support + Type: Full ... **Shift:** Monday - Friday; 8:00am - 4:30pm ET The ** Claims Manager II** is responsible for providing...specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow… more
- Zelis (Atlanta, GA)
- …from providers, clients and internal teams Preferred Qualifications + 7+ years of healthcare claims related experience + People leadership experience with the ... Position Overview The Claims Settlement Manager is responsible for...a better way to determine the cost of a healthcare claim, manage payment-related data , and make… more
- United Site Services (Sacramento, CA)
- …Manager , and ADJ + Communicate any significant changes, problems, or concerns to Claims Manager + Request and monitor settlement requests - provide claim ... summaries to Risk Manager /Sr. Corporate Counsel + Work closely with TPA adjusters...expereince **ADDITIONAL KNOWLEDGE, SKILLS, AND ABILITIES** + Knowledge of data management systems and processes (ie, Outlook, Claims… more
- Humana (Columbus, OH)
- …under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support Services) Manager * Assist pharmacies with claims adjudication * ... Pharmacy Claims Team Leaders and the Pharmacy Claims (Support Services) Manager * Obtain all... where necessary * Ensure accuracy of patient profile data including related/not related status, authorization status, etc *… more
- Trinity Health (Livonia, MI)
- …Reviews. Contacts defense counsel as directed by ACM or Workers' Compensation Claims Manager ; composes correspondence/mail and form letters as directed; ... for both System Office and Ministry colleagues, assisting with data integrity and analytics, preparing state and federal reports,... claims support functions as assigned by Area Claims Manager such as scheduling, calendar management,… more
- TEKsystems (Whittier, CA)
- …to work onsite in Whittier, CA. Must have at least 2 years experience in healthcare claims adjudication. Schedule: M-F, 7 am to 3:30 PM 3 Month Contract- ... Large Healthcare Group is looking for an experienced ...The claims examiner reports directly to the claims manager . They are primarily responsible for… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Coding & Claims - Coordinator 1 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4375274) Coding & Claims - Coordinator 1 Salary Depends ... Description + Benefits Supplemental Information Please clickHERE (https://ulsuno.wd1.myworkdayjobs.com/en-US/UniversityOfNewOrleans/job/Baton-Rouge-La/Coding Claims Coordinator-1\_R-000963-1?q=coding%20&%20claims) to apply. * Reviews and verifies… more
- Elevance Health (Norfolk, VA)
- …you a check, or ask you for payment as part of consideration for employment. **Rating/ Claims System Analyst** + Job Family: IFT > IT Bus Systems Solutions Planning + ... 06, 2024 + Reference: JR111007 **Location:** + VA, NORFOLK **Description** **Rating/ Claims System Analyst** **Location:** This position will work a hybrid model… more
- Elevance Health (Atlanta, GA)
- …strongly preferred + PBM(Pharmacy Benefit Management) Benefits experience preferred + Healthcare experience Strongly preferred + Data analysis and issue ... for payment as part of consideration for employment. **Business Analyst III (Pharmaceutical Claims Audit)** + Job Family: BSP > Business Support + Type: Full time… more
- CommonSpirit Health (Englewood, CO)
- …+ Experience in payer contract analysis and payer process preferred + Experience with healthcare claims and remit data preferred + Experience in medical ... **Responsibilities** **This is a remote position. Seeking a strong manager of technical healthcare teams for Managed...for Managed Care.** **Job Summary / Purpose** The System Manager , Data Engineering is accountable for the… more
- LA Care Health Plan (Los Angeles, CA)
- Financial Compliance Data Manager II Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Financial Compliance Data Manager II is responsible for providing...data standards. Assists in the collection of paid claims data universes for claims … more
- Elevance Health (Richmond, VA)
- …equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Experience with Claims /Provider Healthcare insurance data strongly preferred. + ... part of consideration for employment. **Business Information Developer Consultant ( Healthcare Data )** + Job Family: RDA >...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- HCA Healthcare (Nashville, TN)
- …evaluates, and distributes relevant data concerning patient injuries: aggregate data summaries, monthly trend analyses of incidents, claims profiles, and ... **Description** **Introduction** We are seeking a Risk Manager with TriStar Centennial Medical Center to promote...Center to promote growth and unlock possibilities. At HCA Healthcare , we are committed to the care and improvement… more
- Abbott (Alameda, CA)
- …working with data vendors, managing diabetes market related master data , prescription data and claims data and supporting data consumption. In ... analyze glucose levels. **We are recruiting for a Commercial Data Management Manager to work in our...analytics and KPIs. + Perform adhoc sales, marketing, formulary, claims data analysis for root cause identification… more
- HCA Healthcare (Savannah, GA)
- **Description** **Introduction** Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a ** Manager Risk ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...in our organization. We are looking for an enthusiastic ** Manager Risk Management** to help us reach our goals.… more
- Conduent (Denver, CO)
- …where individuality is noticed and valued every day. **Job Description:** **Senior Manager , Account Management - Government Healthcare ** **Does your client ... to better serve constituents. We offer solutions for Medicaid payments, healthcare , pharmacy benefits management and claims processing. **About the… more