- Stanford Health Care (Palo Alto, CA)
- …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist ... timely and accurate resolution of appeals, ultimately contributing to the financial health of the organization. There are three (3) career banded levels within… more
- Commonwealth Care Alliance (Boston, MA)
- …Alliance's (CCA) diverse provider community - including physician, hospital, behavioral health , community-based, LTSS, and HCBS providers. This individual serves as ... relationships with providers across all specialties -, physician, hospital, behavioral health , community based, and ancillary providers and their staff. + Serve… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is hiring experienced **Healthcare Customer Service Specialists ** to join our remote team! These roles support healthcare members, ... benefits, scheduling, and service coordination + Provide accurate information about health plan benefits, eligibility, and coverage + Schedule, reschedule, and… more
- Jobleads-US (San Francisco, CA)
- …manage a high-performing team dedicated to maximizing revenue and improving the financial health of our eye care practice clients. Reporting directly to the COO, you ... all aspects of the client revenue cycle, including medical coding, claims submission, payment posting, denial management, and A/R follow-up. Develop, monitor,… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... well as a focus on collaborative business relationships, value-based care, population health , or disease or care management. Medical Directors support Humana values… more
- RWJBarnabas Health (Oceanport, NJ)
- …Revenue Cycle, and Patient Access Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding Quality Pay Range:$75,597.00 ... Job Title: Inpatient Coding Quality Officer III - (Medicare) Location: Barnabas Health Corp Department: HIM - Coding Quality Req#: 0000183242 Status: Full-Time… more
- Trinity Health (Livonia, MI)
- …If applicable, telecommuting (working remotely), must be able to comply with Trinity Health 's and the Region/HM Working Remote Policy. **Hourly Pay Range:** ... documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal… more
- RWJBarnabas Health (Oceanport, NJ)
- …Revenue Cycle, and Patient Access Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding South Pay Range:$75,597.00 ... Inpatient Coding Quality Officer I - (All Other Payer) Location: Barnabas Health Corp Department: HIM - Coding Quality Req#: 0000138249 Status: Full-Time Shift:… more
- Centene Corporation (Sacramento, CA)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- CareFirst (Baltimore, MD)
- …technology support, Utilization Management (UM) operations, Clinical Product Configuration, Health Plan Claims /Authorization workflows, or related healthcare ... projects as needed. Maintain a strong working knowledge of the FACETS claims -to-authorization matching workflow and utilize this knowledge to identify and resolve… more
- Humana (Lincoln, NE)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... as well as a focus on collaborative business relationships, value based care, population health , or disease or care management. **Use your skills to make an impact**… more
- Centene Corporation (Jefferson City, MO)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- CareFirst (Baltimore, MD)
- …the Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are included in the job responsibilities. **ESSENTIAL FUNCTIONS:** + Verifies ... changes in industry standards. + Provide guidance and direction to Coding Specialists when reviewing complex medical records to help guide in determining appropriate… more
- The Cigna Group (Newburyport, MA)
- …insurance, and payment information. + _Be a team player_ - Escalate complex claims to the Sr. Billing & Reimbursement Specialists for appropriate action. ... of benefits, with a focus on supporting your whole health . Starting on day one of your employment, you'll...day one of your employment, you'll be offered several health -related benefits including medical, vision, dental, and well-being and… more
- CareFirst (Baltimore, MD)
- …physician review by compiling clinical, contractual, medical policy and claims information along with corporate and appellant correspondence. Formulates ... expert knowledge and all available clinical information for both medical and behavioral health conditions, as well as medical policies, to determine if the adverse… more
- System One (Washington, DC)
- …user guides, training materials, and reference manuals. + Collaborate with business analysts, claims specialists , IT teams, and subject matter experts to gather ... Job Title: Healthcare Technical Writer Location: Remote Type: Contract Compensation: $56/HR Contractor Work Model:...experienced Healthcare Technical Writer with a strong background in health insurance and claims documentation. This role… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …and drive the ecosystem commercial strategy. + Lead a team of Neuroscience Specialists within an ecosystem to drive appropriate clinical demand and improve patient ... sources (eg, analytics) to inform regional business plans. + Coach Neuroscience Specialists to shape customer plans based on market dynamics to address customer… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …outcomes, and compliance objectives. + Lead a team of Neuroscience LTC Specialists within an ecosystem to drive appropriate clinical demand and improve patient ... business plans, with a focus on LTC facilities. + Coach Neuroscience LTC Specialists to shape customer plans based on market dynamics to address customer needs… more
- Banner Health (AL)
- …with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition ... Find out how we're constantly improving to make Banner Health the best place to work and receive care....A typical day would include overseeing RN denials mgt specialists and Audit team, posting bill reviews, and managing… more
- BayCare Health System (Tampa, FL)
- …largest employers within the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the state of Florida, Georgia, South Carolina, or ... Monday - Friday The **Inpatient** **Coding Auditor** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + The Inpatient Coding… more
