- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed ... improve overall claims accuracy and efficiency. The Claims Quality Specialist will work closely with...Diploma or equivalent required **Preferred Qualifications:** + Experience with data analytics tools and software such as SQL, SAS… more
- Axis (Short Hills, NJ)
- …for candidates taking part in the selection process. About the Team AXIS is hiring a Claims Specialist , Health Care Claims , for its North America Claim Team. ... This role involves managing primary and excess healthcare liability claims for AXIS US policies. How does this role contribute to our collective success? You will… more
- Kelly Services (Wichita Falls, TX)
- …always easy. That's where Kelly (R) Professional & Industrial comes in. We're seeking ** Claims Specialist ** to work in a temporary to hire opportunity with a ... taking phone calls from members + Not merely a data entry position **Job Specific Qualifications:** + High School...so let's get to work. Apply to be a Claims Specialist today! As part of our… more
- Enterprise Mobility (Gainesville, FL)
- …is excited to announce opportunities for remote employees to join our Recovery Specialist team! When damage occurs to our company property - primarily our rental ... the communities that we serve, we operate a global network with 80,000 dedicated team members across nearly 100...decisions for settlement strategy + Update system notes and data fields + Document and explain reasons for decisions… more
- Aston Carter (Shreveport, LA)
- …Support SpecialistJob Description We are seeking a dedicated Administrative Support Specialist who excels in customer service and can efficiently handle ... Qualifications + Experience in administrative support. + Familiarity with data entry tasks. + Knowledge of Microsoft Excel. Work...We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients… more
- St. Luke's University Health Network (Allentown, PA)
- …as to ensure compliance with all Federal, state, insurance payer and St. Luke's Network policies. + Analyzes denied claims and investigates the reasons causing ... ability to pay for health care. The Accounts Receivable Specialist I is responsible for the billing and collection...I is responsible for accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance… more
- Henry Ford Health System (Jackson, MI)
- …supervision, performs provider enrollment and compliance functions within a Clinically Integrated Network ( Network ). Key duties include data management, ... . * Serves as the point of contact for Network practices to address claims issues with...fee schedules, and ensure smooth transition of support to Network practice transformation team. * Performs data … more
- Air National Guard Units (Peoria, IL)
- …TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a IT SPECIALIST ( NETWORK ) (Title 32), Position Description Number D2389000 and is part of ... the IL 182 AW, National Guard. Responsibilities As an IT SPECIALIST ( NETWORK ) (Title 32), GS-2210-9/11, you will perform a full range of administrative control,… more
- Air National Guard Units (Macdill AFB, FL)
- …TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a IT SPECIALIST ( NETWORK ) (TITLE 32), Position Description Number D1822000 and is part of ... the FL 290th JCSS, National Guard. Responsibilities As an IT SPECIALIST ( NETWORK ), GS-2210-11, you will design and engineer IT networks carried over various… more
- Air National Guard Units (Syracuse, NY)
- …TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a IT SPECIALIST ( NETWORK ), Position Description Number D2181P01 and is part of the 174TH ... meet the criteria for appointment of annuitants. Responsibilities As a IT SPEC ( NETWORK ) GS-2210-11, you will serve as a base systems administrator to monitor the… more
- Centene Corporation (Columbus, OH)
- … claims payment, and directories. Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution ... most complex provider contracts by researching and partnering to resolve provider claims and data issues. + Act as department subject matter expert. + Performs… more
- St. Luke's University Health Network (Allentown, PA)
- …pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis and procedure codes to assure ... and provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the...diagnosis and procedure codes, and MS-DRG assignment. + Performs data entry of coded patient medical records into EPIC,… more
- St. Luke's University Health Network (Allentown, PA)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... quality. + Identify and provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the medical staff, clinical… more
- CVS Health (Helena, MT)
- …all with heart, each and every day. **Position Summary** - Maintains the Provider Data (demographic and contractual) for all network and non- network ... into applicable systems. **Required Qualifications** - 1-3 years' of Medicaid claims experience. - 1-3 years' Network background. **Preferred Qualifications**… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... and related health plan functions such as member services, claims , and the referral process. As well as functions...but not limited to Kaleida, Catholic Health System, internal data bases as determined based on designated criteria to… more
- Mount Sinai Health System (New York, NY)
- …in analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department ... **Job Description** The Procedural Billing Specialist I is responsible for multiple components of...Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and… more
- Jack Link's (Minneapolis, MN)
- …locations throughout North America, Brazil, Europe, and the Pacific Rim. This global network allows Jack Link's to deliver a wide variety of high-quality, great ... , Mariani and Local Legends Meat Snacks. The Sr. Regulatory Affairs Specialist is responsible for creating and assuring compliance of federally regulated product… more
- Otsuka America Pharmaceutical Inc. (Chattanooga, TN)
- …of everyday health. In Otsuka's evolved customer engagement model, a Neuroscience LTC Specialist will engage HCPs through a variety of in-person, virtual and digital ... and the approved conditions they treat. The Neuroscience LTC Specialist will report directly to the respective Area Business...+ **Territory Analysis / Business Planning** + Uses competitive data and business reports to track progress and uncover… more
- Molina Healthcare (San Antonio, TX)
- …does not entail heavy negotiations. Minimal ongoing engagement after contract. Synchronizes data among multiple claims systems when applicable, and the ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II, D-SNP Team (12 month Assignment) Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more