JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or
JOB SUMMARY: The Cost Containment Specialist is responsible for ensuring CommunityCare receives appropriate reimbursement of payment on claims. The Specialists will take actions such as identification of outstanding overpayment of claims, collection of claim overpayments, handling
Director, HMO Claims Services - 262004305 Description This is a full-time leadership position, eligible for Scripps Health annual Management Incentive Compensation Plan. This position is partial remote and located in San Diego and does require residence in
Claims Examiner The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or
Claims Examiner The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or
Claims Examiner The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or
Claims Examiner The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or
HCSC is seeking a Senior Analytics Consultant to leverage Tableau, SQL, Python, and R to support IL Commercial HMO and Marketplace stakeholders. This role oversees NCQA analytical support and advisory services for internal and external leaders. The
HMO Coordinator The HMO Coordinator plays a critical role in managing and facilitating the operations of Health Maintenance Organization (HMO) plans to ensure seamless healthcare delivery to members. This position involves coordinating between healthcare providers, insurance companies, and members
# Senior Analytics Consultant - HMO & Quality Analytics - Work From HomeApplyremote type: Remotelocations: TX - Richardson: MT - Helena: NM - Albuquerque: OK - Tulsa: TN - Nashvilletime type: Full timeposted on: Posted Yesterdayjob requisition
Job Title Responsibilities: Run the AR every 4 weeks. Make sure the claims were paid correctly. Denials must be checked, sent appeal, check authorization and eligibility. Make phone calls if the denial is not clear, have
This position will be posted for a minimum of 5 days The mission of the Colorado Coalition for the Homeless is to work collaboratively toward the prevention of homelessness and the creation of lasting solutions for
Tool and Die Maker Why join OTTO Engineering? At OTTO, we don’t just manufacture products - we engineer mission-critical solutions with precision and pride. Our Tech Center showcases cutting-edge technology with complete engineering capabilities for designing,
Divergent is a technology company that has architected, invented, built, and commercialized an end-to-end factory system called the Divergent Adaptive Production System (DAPS) that comprehensively uses machine learning to optimally engineer, additively manufacture, and flexibly assemble
About Altruist Altruist is transforming the multi-trillion dollar wealth management industry by building an AI platform for wealth professionals. We partner with financial advisors nationwide, empowering them to grow, optimize time and resources, and deliver superior
Discover Your Career at Emory University Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to
We are so glad you are interested in joining Sutter Health! Organization:SMCS-Valley Administration Position Overview:Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician,
The Financial Clearance Specialist IV is responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete. Documentation of accurate insurance information, knowledge of insurance plans and authorization details to optimize reimbursement from the
Fleet Mechanic Pay: $27.00-$29.00 per hour Start your career at the BEST Home Service Company in the state of Michigan! For over 50 years, Modernistic has provided our community with exceptional cleaning and restoration services throughout
Our Purpose is to change the way the world eats and to deliver on that purpose Our Goal is to be a great place to work where you can learn, grow, and develop both personally and