- Highmark Health (Annapolis, MD)
- …charges. The incumbent will also conduct or assist with provider and subscriber investigations to verify the validity of services and charges; will monitor internal ... facility and professional provider over-payments. + Investigation Support: Assist with investigations : Assist in the interviews of customers and providers to obtain… more
- Exelon (Upper Marlboro, MD)
- …coaching, training, and evaluate employee performance. Assist in Root Cause Investigations (RCI), Apparent Case Evaluations (ACE) and /or Condition Report ... coaching, training, and evaluate employee performance. Assist in Root Cause Investigations (RCI), Apparent Case Evaluations (ACE) and /or Condition Report… more
- Delmock Technologies, Inc (Laurel, MD)
- …Laurel, MD 20707. Role: Delmock Technologies, Inc. is seeking a Project Coordinator / Executive Operations Manager, Office of the CIO, to provide high-level ... and meeting minutes. Prepares documentation for Commission and leadership meetings, investigations , and special projects; attends meetings to support the CIO as… more
- Cardinal Health (Annapolis, MD)
- …regulations, standards and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- Cardinal Health (Annapolis, MD)
- …+ Experience conducting and documenting patient health insurance benefit investigations , prior authorizations, and appeals, preferred (2+ years) + Knowledge ... of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of Medical/Pharmacy billing and coding, preferred + Strong attention to detail is vital + Bilingual, preferred… more
- Cardinal Health (Annapolis, MD)
- …of applicable regulations, standards, and operating procedures. + Conduct investigations /root cause analysis and formulate corrective action recommendations. + Show ... an understanding of the program requirements and be capable of conducting gap assessments based on those requirements. + Uphold quality standards that adhere to company, regulatory, and HIPAA policies and procedures. + Collaborate across various functions,… more
- Cardinal Health (Annapolis, MD)
- …regulations, standards, and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- BioLife Plasma Services (Forestville, MD)
- …Refer to EHS guidance regarding employee incidents. You can be a Pandemic Coordinator when authorized by EHS and support investigations associated with pandemic ... threats within the local community as indicated by EHS or Medical Affairs. What you bring to Takeda: High school diploma or equivalent to including graduate equivalent of a recognized educational nursing program with state requirements Currently licensed or… more