- Chick-fil-A (Ballwin, MO)
- …training and development, records management, safety and health (workers compensation claims ), succession planning, employee relations and retention, AA/EEO ... process, organizes all applications, knows applicant status, and consistently improves to provide a remarkable experience for all new employees Assist and leads… more
- Molina Healthcare (Buffalo, NY)
- …in New York _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...ABILITIES** : * 3 - 5 years customer service, provider service, or claims experience in a… more
- Molina Healthcare (Los Angeles, CA)
- …in California _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a… more
- Centene Corporation (Augusta, ME)
- …to identify and strategizes opportunities for provider improvement. + Collaborates with Provider Relations to improve provider performance in areas of ... barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction with members and providers at… more
- TEKsystems (Columbia, SC)
- …research as needed to resolve inquiries. *60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, ... our customers through the details of their benefit plan, claims processes, and their rights as customers of our...- easy. During a typical day, a Customer Service Advocate may assist one customer with scheduling a doctor… more
- MTA (Jamaica, NY)
- … - Railroad Operations and Director - Labor Relations on current labor relations issues. Provide consultation and expert advice to management or other groups ... within time limits. Calculate the cost or liability of claims . Negotiate stipulations of settlement where appropriate. Analyze cases...Relations - Railroad Operations and Director - Labor Relations at various meetings as needed. Provide … more
- TEKsystems (Columbia, SC)
- …research as needed to resolve inquiries. *60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, ... GAPS WITHIN THEIR WORK HISTORY, PLEASE HAVE THEM TO PROVIDE A REASON. Required Education: High School Diploma or...Diploma or equivalent Required Work Experience: 1 year of claims processing or customer service experience OR Bachelor's Degree… more
- McLaren Health Care (Flint, MI)
- … for the Provider , supplying information and education, working with Provider Relations to handle issues. Also responsible for assisting members with ... risk arrangements and actuarial precepts). + In-depth understanding of claims administration as it pertains to provider ...of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes,… more
- McLaren Health Care (Indianapolis, IN)
- … for the Provider , supplying information and education, working with Provider Relations to handle issues. Also responsible for assisting members with ... risk arrangements and actuarial precepts). + In-depth understanding of claims administration as it pertains to provider ...of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes,… more
- The Cigna Group (Sunrise, FL)
- …Healthcare Provider /Ancillary group experience required** + **1+ years prior Provider Servicing/ Provider Relations experience strongly preferred** + ... need to work in the office or visit Providers 3 days per week The ** Provider Contracting Lead Analyst** serves as an integral member of the Provider Contracting… more
- Corewell Health (Grand Rapids, MI)
- …Organization strategy will be supported by coordinating with Medical Policy and Provider Relations teams to effectively plan and execute program tactics. ... will support the organization's cost containment efforts specific to medical claims payment and drive payment integrity performance. This position is responsible… more
- Corewell Health (Farmington Hills, MI)
- …will drive proactive risk reduction strategies, collaborative initiatives with Patient Relations and Patient Experience teams, and innovative approaches to improve ... of patient related injuries and manage the resolution of pre-notice claims . Essential Functions + Reviews and provides recommendations regarding the development… more
- The County of Los Angeles (Los Angeles, CA)
- …permanent appointment to Community Health Worker. Essential Job Functions Facilitates relations between the agency and the community by communicating agency policies ... housing, medical, mental health, or substance use care. Serves as an advocate for client/patient access to departmental and community resources. Assists clients,… more
- Win (Women In Need) (New York, NY)
- …to monitor and investigate reports of employee misconduct, harassment, retaliation and other claims . + Provide advice and counsel to managers as investigations ... the Opportunity Win is a leader and the largest provider of shelter, supportive housing, and groundbreaking programs in...the department's leadership team to analyze PC challenges and provide solutions that will impact a positive work environment.… more
- Army National Guard Units (Baltimore, MD)
- …justice and status issues for Title 10 and Title 32 members; claims ; labor relations ; equal opportunity; administrative actions; contractual agreements; ethics; ... that recommendation to the SJA. Assists the Staff Judge Advocate with implementation of the joint ethics regulatory annual...claims . To receive credit for Education, you must provide documentation of proof that you meet the Education… more
- The Cigna Group (Bloomfield, CT)
- …utilization management, case management, network, contracting, pharmacy, and service operations ( claims ). Primarily regional with national level case work for Cigna ... Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state… more
- City of New York (New York, NY)
- …guidelines. The work of DFS includes managing the ACS budget; submission of monthly claims for revenue; processing of payments to provider agencies and vendors; ... monitoring the financial health of provider agencies through financial review and audits; maintenance of the ACS bank accounts; centralized oversight of ACS Child… more
- Ducommun (Coxsackie, NY)
- …all areas of HR including recruiting, benefits administration, employee relations , training, development, orientation, data administration and documentation, talent ... Ducommun Way methodology to achieve objectives. + Drive strong employee relations through frequent and clear communications, clarity of expectations, and promoting… more
- City of New York (New York, NY)
- …guidelines. The work of DFS includes managing the ACS budget; submission of monthly claims for revenue; processing of payments to provider agencies and vendors; ... monitoring the financial health of provider agencies through financial review and audits; maintenance of the ACS bank accounts; centralized oversight of ACS Child… more
- Highmark Health (Pittsburgh, PA)
- …across all aspects of the Medicaid business, including member enrollment, claims processing, care management, and quality improvement. Implement best practices to ... processes, reduce administrative costs, and enhance the member experience. + ** Provider Network Management:** Develop and maintain a high-quality provider … more
