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Job Search Results
1 to 50 of 2,613 for Medical & Health; Case Management; Dental; Doctor & Practitioner; Health Administration; Imaging; Lab & Technology; Medical Billing; Medical Coding; Medical Research; Mental Health; Nursing; Nutrition; Pediatric; Pharmaceutical; Therapy
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New! YesterdayLead the enterprise project management team, providing guidance, mentorship, and professional development opportunities to project managers. Establish and enforce project management methodologies and best practices across the organization. Develop and...
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New! YesterdayAccounts Receivable Medical Billing Specialist needed for a remote position. Job Responsibilities Include: Full Life Cylce of claim through resolution, AR Follow Up, Denials, Appeals, Rejected Claims, Payment Posting.
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FeaturedNew! YesterdayWork directly with the study teams: in the development of clinical research documents including research protocols, informed consent documents, case report forms, study team worksheets and other documents; to guide the preparation of regulatory agency...
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New! YesterdayResponsible for the implementation of any new client\network or vendor relationship using Electronic Data Interchange. Build and maintain relationships with our adjudication system partners and other vendors; serve as liaison to bridge gaps between...
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New! YesterdayReviews and assesses the current state of the existing resources and makes recommendations to enhance those resources and/or generate new resources that will enhance the performance of the department associates. Identifies process improvements and...
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New! YesterdayMaintains ownership of and manages contract process to ensure timely delivery and execution consistent with standard cycle times, including but not limited to, the coordination and finalization of the contractual instrument and budget to align with...
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New! YesterdayWriting, editing, and proofreading content. Follow internal processes to secure needed legal and security documents in support of RFP/RFI and due diligence compliance. Ensure that the right internal intelligence is collected to help make strategic...
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New! YesterdayAs a Virtual Therapist, your primary responsibility will be to provide world-class mental health care to children and adolescents within our partner school districts. You will interact and build relationships with school personnel, family members, and...
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New! YesterdayProvide virtual high-quality, evidence based, and culturally relevant short-term solution focused therapeutic interventions, treatment and consultation for children in grades K-12. Collaborate with care management team to identify and support...
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New! YesterdayProvide virtual high-quality, evidence based, and culturally relevant short-term solution focused therapeutic interventions, treatment and consultation for children in grades K-12. Ensure that all documentation is completed accurately and in a timely...
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New! YesterdayThe role is responsible for collecting payments from various insurance companies. Collections activities include denial research, submission of appeals, and follow up on no-response and partial paid claims. This includes identifying consistent payer...
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New! YesterdayDevelop financial pricing strategies through complex technical analysis. Prepare reports using benchmark data to analyze and forecast pricing simulation impacts. Perform post-implementation revenue and budget variance analyses to monitor strategy...
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New! YesterdaySupport the Quality Management System including SOPs, training and CAPA. Process and maintain documentation for controlled documents, as required. Develop and administer training for employees and/or consultants. Host client/sponsor audits and support...
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New! YesterdaySupports the market and strategic analysis activities as they relate to near and long-term strategic planning and the analysis of business opportunities within the corporation. Facilitates multi-disciplinary teams that may consist of executives...
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New! YesterdayInvestigate attendance and quality incidents for the thousands of workers across our marketplace; uses exceptional judgment and noticing to make decisions on difficult cases and ability to articulate reasoning in a clear and concise manner. Communicate...
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New! YesterdayThe position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Ensure notes, codes and appropriate closure processes for...
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New! YesterdayThis role will support our Medicare Secondary Payer (MSP) clients. This is aproduction based position where the employee is responsible to make a large number of outbound calls to insurance carriers, employers & members. The individual must be able to...
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New! YesterdayProvide virtual high-quality, evidence based, and culturally relevant short-term solution focused therapeutic interventions, treatment and consultation for children in grades K-12. Ensure that all documentation is completed accurately and in a timely...
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New! YesterdayFocus in either Utilization Management/Care Management/Denials Management and expected to be cross trained to allow critical coverage for all areas as needed, including but not limited to: UM case review, peer-to-peer review for medical necessity...
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New! YesterdayIdentifies product enhancements based on client interactions and works with the Product Management and Software Engineering groups to design solutions for client requirements. Develops and maintains relationships with clients, partners and internal...
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New! YesterdayMaintains a comprehensive knowledge of Department of Health and Human Services (DHS), National Committee on Quality Assurance (NCQA), Office of Minority Health (OMH) and other regulatory standards related to health equity and Cultural and...
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New! YesterdayWorking from the appropriate documentation in the medical record, assigns codes and modifiers with ICD-10-CM, CPT and HCPCS Level II codes when appropriate. All work is performed in accordance with the rules, regulations and coding conventions of ICD...
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New! YesterdayThe Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...
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New! YesterdayAttend cases face to face/remotely with our customer and advise physicians on clinical attributes/techniques associated with our products. Records customer information and activities in company's Customer Relations Management System: use the system as...
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FeaturedNew! YesterdayPerform and coordinate all aspects of the clinical monitoring process. You shall also be qualified to conduct monitoring activities independently. Bachelor's degree in a life sciences related field or a Registered Nursing certification or equivalent...
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New! YesterdayThe Operations Business Analyst II is responsible for reviewing and analyzing the effectiveness and efficiency of existing managed care claims processes and systems (Facets) and participates in the development of solutions to improve or further...
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New! YesterdayThis role will be responsible for 1) coordinating work efforts related to the Corporate Compliance Program across business units and departments, and 2) standardizing and aligning organizational guidance around applicable compliance standards and...
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New! YesterdayUnderstand the Claims Encounter Data requirements in detail to enable one to support efforts to ensure claims data submissions achieve the required SLAs through requested changes internally and externally.
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New! YesterdayResponsible for evaluating operations and identifying process improvement needs. Identify irregular trends with grievances and appeals; work with other areas as appropriate to identify root causes and appropriate steps for resolution.
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New! YesterdayReview, analyze, evaluate and compose a comprehensive rebuttal via the appeal process in a timely manner to the DRG denial claims for clinical and coding denials that are received from the insurer/auditor. Successful appeals result in our upholding the...
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New! YesterdayExamines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.
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New! YesterdayPositions patient and performs imaging procedure(s). Analyzes results and identifies issues with the quality of imaging results. Takes appropriate action to resolve image quality issues, including re-positioning patient and repeating procedure.
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New! YesterdayThe regional Auditor position will manage the relationships, initiation, inside communication, workflow, progress, and completion of audit program projects for the SE region of the company. This position requires great attention to detail, excellent...
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New! YesterdayReview clinical information for appropriateness, congruency, and accuracy as it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. Review and communicate OASIS edit recommendations to each clinician...
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New! YesterdayResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in...
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New! YesterdaySeeking a Senior Innovation Portfolio Strategy Professional who will play a critical role in the evolution of our innovative solutions and, more broadly, in helping Humana deliver on its well-being centered mission. They will support the oversight and...
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New! YesterdayRespond to and control the disposition of all assigned Michigan No-Fault claims. Work with computer systems keying functions, including but not limited to letter composition, log entry, diary entry, report of investigation composition, and draft...
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New! YesterdayOwn the development of the lead-to-conversion journey, aiming to increase the adoption of value-added products and services through email and website channels. Collaborate with clinical and care teams to create and refine effective programs that...
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New! YesterdayManage company-wide strategic programs (e.g. expansion of services, adapting operations to legislative changes, develop new revenue stream GTM strategy), including design, process definition, project management, analysis and insights, and...
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New! YesterdayReporting to the Senior Manager of Professional Billing and Revenue Cycle, the Manager of Professional Billing and Revenue Cycle will be the revenue cycle representative between designated department(s), the Professional Billing office, third-party...
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New! YesterdayParticipate in the complex analysis, research, and interpretation of data, including but not limited to identifying cost, financial, marketing, and contracting opportunities. Generate custom statistical and analytical reports as requested by consultants.
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New! YesterdayBe responsible for maintaining the integrity of the content of the company's Epic electronic health record by performing in-depth investigations of questionable data entry and correcting as appropriate or advised. The Data Integrity Specialist...
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New! YesterdayThis position will require you use the skills you have built in your behavioral health sales and marketing career. You will need to analyze the market, identify opportunities to grow our brand recognition and referral base, and plan and execute...
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New! YesterdayThis role oversees the content database that is currently being used by the Questionnaire Team, RFP Manager Team, Strategic Relationship Team, and more. They will coordinate with all team members as well as with Subject Matter Experts across the...
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New! YesterdayPartner with marketing and research teams to support their strategies and meet their customer needs. Anticipate market trends and proactively adjust strategy based on healthcare environment. Monitors regulatory and environmental issues and considerations.
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New! YesterdayResponsible for implementation of regulatory strategies including domestic and international submissions, regulatory support through the product life cycle on product project teams, and timely review and approval of product labeling, marketing claims.
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New! YesterdayThe Nurse Enrollment Specialist (RN) will be responsible for performing case reviews and phone assessments of patients to determine eligibility in our active clinical trial studies. This position will be integral to our Recruitment Operations team and...
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New! YesterdayPerform clinical/coding medical claim review to ensure compliance with coding practices through a comprehensive review and analysis of medical claims, medical records, claims history, state regulations, contractual obligations, corporate policies and...
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New! YesterdayBe responsible to locate and notify payers of underpayments and work denials by telephone, email, and/or fax to ensure prompt and efficient collection. Contact patients by phone and/or mail regarding their accounts and is responsible for ensuring the...
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New! YesterdayManage the development of the regional product label by collaborating with the Labeling Working Group to define commercial objectives in the context of available and expected scientific data, regulatory guidance and precedent.
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