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 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
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
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
At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health
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
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
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
Join the Team Modernizing Medicine At ModMed, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: we hired
Apply now to join FAU on its race to excellence. For more information on everything FAU has to offer, please visit www.fau.edu/jobs. Note: Current FAU employees must apply as an internal applicant by logging into their
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united
About Trinity Property Consultants At Trinity Property Consultants, your expertise fuels our mission. Guided by our values of innovation, teamwork, excellence, and empowerment, we’ve been a leader in the multifamily industry for over 25 years and