• Claims Operations Manager…

    CareFirst (Fairfax, VA)
    …leadership. **Knowledge, Skills and Abilities (KSAs)** + Knowledge of call center operations claims and/or enrollment and billing and workflows. + Strong ... support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations . Investigates and… more
    CareFirst (05/08/25)
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  • Provider Relations Representative - BH

    Humana (Arlington, VA)
    …role should have critical thinking/problem solving skills, understanding of health plan operations , and strong interpersonal skills. + Serve as primary relationship ... manager with assigned LTSS and HCBS providers to ensure...where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals) + Work with… more
    Humana (05/14/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Washington, DC)
    …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
    Humana (05/10/25)
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