- LA Care Health Plan (Los Angeles, CA)
- Enterprise Shared Services Program Manager II (Limited Duration) Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support ... safety net required to achieve that purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a portfolio of… more
- Commonwealth Care Alliance (Boston, MA)
- …**Experience Desired:** + Agile & Scrum experience + Experience working in the healthcare payer space + Experience with X12 EDI transaction sets for Healthcare, ... require technology solutions to achieve business outcomes. The portfolio manager ensures that IT solutions are best-in-class and align...of the enrollment and claims lifecycles of a medical payer + Knowledge of EDI protocols and… more
- Trinity Health (Boise, ID)
- …+ Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (primarily EDI transactions and payer web access, and in some cases ... + Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired… more
- Trinity Health (Ontario, OR)
- …of services patients will receive. + Performs insurance eligibility/benefit verification utilizing EDI transactions and payer web access and calls payers ... inquiry issues, then communicates the results. + Identifies routine payer or provider issues and escalates to Lead Patient...+ Other duties as needed and assigned by the manager . + Maintains a working knowledge of applicable Federal,… more
- CVS Health (Cumberland, RI)
- …Through the company's more than 7,600 CVS/pharmacy stores; its leading pharmacy benefit manager serving more than 60 million plan members; and its retail health ... of medical claims that have denied by refuting the denials within payer guidelines through accurate review, correction, and resubmission Provide representation when… more
- Trinity Health (Chelsea, MI)
- …point of service, performs insurance eligibility and determines benefit verification, utilizing EDI transactions and payer web access, and calls payers directly. ... by the Patient Access Lead. Other duties as needed and assigned by the manager . Maintains a working knowledge of applicable Federal, State, and local laws and… more