- Lincoln Financial Group (Denver, CO)
- …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- BrightSpring Health Services (Longmont, CO)
- …7 business days Responsibilities * Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, ... focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail...join our team and apply today! We are seeking Claims Supervisors with 3rdparty claims experience. Pharmacy… more
- Humana (Denver, CO)
- …to drive improvements in quality and/or reductions in total cost of care + Scorecard creation and reconciliation of provider performance based on contractual ... Qualifications:** + Bachelor's Degree + 3-5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care +… more
- BrightSpring Health Services (Longmont, CO)
- …you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization ... retail to office environment for those who are willing to learn claims , billing and insurance processing. Pharmacy Technician experience and/or knowledge of… more
- BrightSpring Health Services (Longmont, CO)
- …where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our ... and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your… more
- BrightSpring Health Services (Longmont, CO)
- …you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization ... office environment for those who are willing to learn claims , billing and insurance processing. Pharmacy Technician experience and/or...pharmaceuticals is a strong preference. This is NOT a remote postion. Must reside in or within a commutable… more
- BrightSpring Health Services (Longmont, CO)
- …where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our ... and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your… more
- Marriott (Denver, CO)
- …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
- BrightSpring Health Services (Longmont, CO)
- …where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our ... and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your… more
- Humana (Denver, CO)
- …determine who can work them and then assigning the case to the next available associate to work. You will be responsible for communicating via email and MedHok to ... focused on continuously improving consumer experiences **Preferred Qualifications** + Associate 's or Bachelor's Degree + Previous experience with MedHok, PaHub,… more
- Humana (Denver, CO)
- …hands-on experience with healthcare data such as medical, behavioral, pharmacy claims data, financial, social and demographic data; demonstrated innovative and ... experience in health insurance domain, familiarity with products, providers and claims processing. + Experience with Data Warehousing (Azure/SQL/Synapse), ETL (Azure… more
- BrightSpring Health Services (Longmont, CO)
- …where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our ... and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your… more
- Humana (Denver, CO)
- …more years of experience with CMS and/or AHCA compliance + 2 or more years Claims experience + 2 or more years Audit and/or Financial Recovery experience + SQL ... structure and design **Preferred Qualifications** + Direct experience working with Medicare claims + Working knowledge of CPT, ICD10 and HCPC + Provider contract… more
- Humana (Denver, CO)
- …to business & customers we serve using the latest in software technology? Our claims services team is best positioned in building modernized claims eco systems ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
- Elevance Health (Denver, CO)
- …Practice Enablement Clinician** **Location** : This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from one ... key strategic solutions that involve practice collaboration and enablement to improve member care quality and value. Serves as a strategic solution lead for Oncology… more
- Humana (Denver, CO)
- …**Preferred Qualifications** + Appeals/Utilization Review/Quality Management experience + Previous claims experience + Experience working with MCG guidelines + ... HCPCS, DRG use + Experience with TRICARE contracts and/or the military health care delivery system + Knowledge of TRICARE policies and programs + Bachelor's degree… more
- El Paso County (Colorado Springs, CO)
- …you will be responsible for conducting in person fieldwork to investigate claims of physical abuse, sexual abuse, caretaker neglect, self-neglect, and exploitation ... Caseworker - Adult Protective Services career progression series, which includes Associate Social Caseworker - Adult Protective Services and Social Caseworker -… more
- Humana (Denver, CO)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Denver, CO)
- …+ Intermediate to advanced experience in programming, analytical work, and with claims data. + Familiarity or prior experience with data governance and literacy. ... requirements and guidelines. **Additional Information** + **Travel** : None + **Workstyle:** Remote + **Core Workdays & Hours:** Typically, 8-5 pm Monday - Friday;… more
- Humana (Colorado Springs, CO)
- …volumes of data + Good understanding of healthcare data eg, member, provider, claims and clinical data + Experience and understanding of data governance practices ... **Location/Work Style:** Hybrid Office in Louisville, KY is preferred but open to Remote US as well **Why Humana?** At Humana, we know your well-being is… more