- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist , you will work with internal teams to provide cutting-edge solutions that will directly ... improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment...and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,… more
- Northern Light Health (Brewer, ME)
- …and developing corrective actions. .Working knowledge of functional areas of the healthcare and contracting departments impact on such .Excellent communications ... Northern Light Health Department: Managed Care Contracting Position is located: Cianchette Professional Blding Work...serve as an internal consultant with strong financial and healthcare business acumen as well as the ability to… more
- Molina Healthcare (TX)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Responsible for contracting /re- contracting of ... and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates in other contracting related special projects as… more
- Molina Healthcare (Los Angeles, CA)
- …ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's ... California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with… more
- Molina Healthcare (NY)
- …York _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance… more
- Elevance Health (Woodland Hills, CA)
- …provide an equivalent background. **Preferred Skills, Capabilities & Experiences :** + Healthcare related claims experience highly preferred. + MS Office ... **Plan to Plan Service Specialist I** **Location :** Ideal candidates will live...of contact in responding to all Plan to Plan claims inquiries and resolving related issues. Plan to Plan… more
- Veterans Affairs, Veterans Health Administration (Fargo, ND)
- Summary The incumbent serves as a Supervisory Mobility Transportation Specialist - Mobility Manager and manages all Veterans Transportation System (VTS) and ... including patient transport, Special Mode Travel (SMT), mileage reimbursement claims , transportation contracts, 911 ambulance claims , inter-facility transfers,… more
- Veterans Affairs, Veterans Health Administration (White River Junction, VT)
- …EXTEND THE CLOSING DATE Employee will serve as a Supervisory Mobility Transportation Specialist located at the Veterans Healthcare System in White River ... including patient transport, Special Mode Travel (SMT), mileage reimbursement claims , transportation contracts, 911 ambulance claims , inter-facility transfers,… more
- CareOregon (Portland, OR)
- …Work closely with other internal departments, including, but not limited to Claims , Utilization Management, Credentialing, Provider Data, and Contracting to ... Job Title Provider Relations Specialist Lead - Behavorial Health Department 116-Provider Relations...to enhance the provider experience, quality of care and healthcare transformation. + Act as a key liaison to… more
- TEKsystems (Honolulu, HI)
- …Provider Network Management Specialist . 1-2 years of experience working in the Healthcare industry and exposure to claims processing and medical billing is ... group provider relationships with the client including provider recruitment, standard contracting , onboarding, claims training and resolution of providers'… more
- CareOregon (Medford, OR)
- …contractor and must comply with all federal laws. Job Title Provider Relations Specialist I Department 116 - Provider Relations Exemption Status Exempt Requisition # ... Work may be focused on physical, behavioral, and/or community-based healthcare services. Essential Responsibilities Provider Development & Education + Develop… more
- Providence (OR)
- …**Required qualifications for this position include:** + 2+ years of healthcare administration experience (Experience to include: Claims , Customer Service, ... them._** **Providence Health Plan is calling a Provider Data Specialist who will:** + Be responsible for the management...contracts + Be the main point of contact for contracting , contracting questions and education + Be… more
- Amergis (Chicago, IL)
- …in: provider data management, credentialing or healthcare operations (ie claims processing, billing, provider relations, or contracting ) experience within a ... / hour Amergis is seeking a Provider Data Operations Specialist facilitates all provider data upload files for the...Excel, specifically formula set up to upload rosters and claims as this is a primary function of the… more
- Centene Corporation (Getzville, NY)
- … related field preferred. 5+ years of sales, provider relations, or contracting experience. Claims processing and/or managed care experience preferred. Driver's ... the health plan and Corporate to investigate and resolve provider claims + Conduct on-site provider orientations, including writing and updating orientation… more
- Guthrie (Sayre, PA)
- Position Summary: The Provider Enrollment Specialist reporting to the Payor Contracting & Provider Enrollment Manager plays an essential role in ensuring the ... provider demographics and credentials in the Council for Affordable Quality Healthcare (CAQH) national credentialing database. 4. Completes monthly and quarterly… more
- Sutter Health (Los Altos, CA)
- …risk contracts under design. Ensures successful contract performance. Assists with the contracting process to develop and expand of our provider networks. Audits ... administration of Managed Care lives. Provides analytical support for budgeting and contracting in addition to offering support and ongoing education to the provider… more
- Magellan Health Services (Boise, ID)
- …Care/ Healthcare environment with experience in eligibility, authorization and claims problem resolution. 2+ years' experience in network development with ... extensive experience working directly with tribal governments. + Tribal healthcare experience preferred. + The Liaison will be the...demonstrated focus on contracting and rate negotiation. Excellent organizational and rate negotiation… more
- Randstad US (New York, NY)
- credentialing specialist . + new york , new york + posted 10 days ago **job details** summary + $28 - $28.58 per hour + temp to perm + high school + category office ... applicable databases with relevant information for credentialing and insurance contracting . *Assists in uncovering and resolving doctor credentialing questions… more
- Sedgwick (Columbus, OH)
- …equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting , servicing and ... Most Loved Workplace(R) Forbes Best-in-State Employer Provider Network Negotiation Specialist **PRIMARY PURPOSE** **:** To negotiate fee-for-service ancillary contracts… more
- Centene Corporation (Tucson, AZ)
- …in related field or equivalent experience. 2+ years of combined managed healthcare and provider reimbursement experience. Claims processing and/or managed care ... Educate providers regarding policies and procedures related to referrals, claims submission, credentialing documentation, web site education, Electronic Health… more