- Trustmark (Frankfort, KY)
- …our colleagues, clients and communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & ... of claim handling process and procedures and experience in handling claims appropriately in accordance with the corporate claim philosophy, policy provisions… more
- Molina Healthcare (Louisville, KY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... management and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and developing SOPs and/or BRDs. +… more
- Signature Healthcare (Louisville, KY)
- …cognitive care, and telemedicine. A growing number of our centers are earning quality assurance accreditation and pioneering person - directed care. Many of our ... may not be limited to: managing administrative (survey) and other legal claims against company; interfacing with outside legal counsel; administering the company's… more
- Intermountain Health (Frankfort, KY)
- …of actual and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as ... hospital personnel as needed. + Acts as a mentor. As assigned, coordinates training , direction and review of those working with reimbursement functions. + Manages… more
- Highmark Health (Frankfort, KY)
- …reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. ... disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services)… more
- CenterWell (Frankfort, KY)
- …**Key Responsibilities:** + **Operational Reporting:** Oversee the medical and prescription claims processes, including quality , audits, and reporting. Manage ... community and help us put health first** As a Sr . Business Intelligence Engineer for CenterWell Primary Care, you...operations & BI reporting and a passion for data quality and process improvement. The ideal candidate will have… more
- Prime Therapeutics (Frankfort, KY)
- …our passion and drives every decision we make. **Job Posting Title** Senior Health Outcomes Researcher - Remote **Job Description** The Health Outcomes Researcher ... focused on drug utilization, combined medical and pharmacy drug claims , with a view to the impact on patient...of Principal Health Outcomes Researcher, Principal Data Scientist, or Sr Dir Health Outcomes, define and document complex study… more
- Cherry Bekaert (Frankfort, KY)
- **Description** **Summary of Responsibilities:** The Senior Associate will work closely with the Cherry Bekaert FAO (Finance & Accounting Outsourcing) team, ... for our clients in the insurance, service and related industries. The Sr . Associate will also assist in an administrative project management capacity, spearheading… more
- United Therapeutics (Frankfort, KY)
- …practices, you drive a culture of compliance with confidence and enthusiasm. The Senior Corporate Compliance Manager - Training , Communications and Policy will ... experiences. Detail-oriented yet creative, you balance policy management with innovative training strategies that resonate across all levels of the organization. You… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission ... considerable latitude in determining objectives and approaches to assignments. The Senior Encounter Data Management professional ensures data integrity for claims… more
- Atlas (Louisville, KY)
- …at any and every step of the project, and with a heart-led approach that puts quality and safety at the center of everything we do. We're just built to be better. ... Description** Atlas is looking for someone to join our Legal Team as ** Senior Litigation Counsel (Engineering / Construction)** to be located in one of our… more
- Molina Healthcare (Louisville, KY)
- …jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core ... subject matter expertise to successfully engage high priority providers, including senior leaders and physicians, to ensure provider satisfaction, education on key… more
- Walgreens (Louisville, KY)
- …certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician. + Attends training and completes PPLs requested ... and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the Walgreen...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Zurich NA (Frankfort, KY)
- Senior Construction Risk Engineering Consultant 122827 Senior Construction Specialties Risk Engineering Consultant: Midwest/Plains states or South-Central region ... Eastern Texas, Western Tennessee. Zurich is currently looking for a Senior Construction Risk Engineer for the Builders Risk/Construction Property Line of… more
- CenterWell (Frankfort, KY)
- …of our caring community and help us put health first** The Senior Pharmacy Contracting Professional is responsible for reporting, implementation, and maintenance of ... Humana's Healthy Horizon Medicaid business. The Senior Pharmacy Contracting Professional work assignments involve moderately complex to complex issues where the… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Senior Financial Reporting Professional/ Analyst prepares and distributes periodic financial statements ... other than those directly employed by the organization. The Senior Finance Reporting Professional/ Analyst + Analyzes and forecasts...all business areas such as: Finance, Network, Health Services, Claims and Actuarial **Use your skills to make an… more
- Prime Therapeutics (Frankfort, KY)
- …passion and drives every decision we make. **Job Posting Title** Senior Functional Business Consultant/ Regulatory Compliance exp required- REMOTE **Job ... analysis, complex issue research, documentation, advanced communications, client interaction, training , testing, ongoing system support, and developing reports and… more
- Highmark Health (Frankfort, KY)
- …of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care ... actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to… more
- BrightSpring Health Services (Louisville, KY)
- …focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh ... role is based out of Louisville, KY and after training , will become a hybrid schedule with time spent...centers nationwide. If your passion is service excellence and top- quality care come join our team and apply today!… more
- Carrington (Frankfort, KY)
- …pay for this position is $31.73 an hour. **What you'll do:** * Provides training , creates and updates Policy & Procedures, and reviews control reports to ensure ... overall quality and performance of the Bankruptcy processes * Handles...with recommendations and solutions. * Conduct informal and formal training sessions with the staff on the bankruptcy processes.… more