- Highmark Health (Frankfort, KY)
- …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
- Aston Carter (Harrodsburg, KY)
- …with your resume if you're interested in learning more ###@astoncarter.com!Job Title: HR Coordinator Job Description As an HR Coordinator , you will play a ... compliance, track safety training, and manage PPE. + Assist with safety investigations and policy violations. + Promote team engagement and help organize recognition… more
- Cardinal Health (Frankfort, KY)
- …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
- CVS Health (Frankfort, KY)
- …product or contract drafting; compliance and regulatory analysis; special investigations ; provider relations; customer service or audit experience. **Preferred ... Qualifications** -Experience in research and analysis of claim processing a plus. **Education** -Some college preferred. -High School or GED equivalent. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role… more
- Cardinal Health (Frankfort, KY)
- …+ 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 (Frankfort, KY)
- …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 (Frankfort, KY)
- …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