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13 Jobs

  • Vice President Claim Payment Administration

    Newtown Square, Pennsylvania
    ... the enterprise claims and provider platform, process improvement through robotic automation and ... Management, Claims, Capitation, Enrollment Provider Relations, Finance, etc., to provide RPA, payment ...
  • Health Services Plan (HSP) Team Lead - Remote, USA

    Remote, United States
    ... :** The Team Lead's primary responsibility is supporting the daily claims process. Secondarily, they are ... :** Reports to LOB Supervisor. Functions as a technical specialist for claims operations. Maintains ...
  • HSP Team Lead - Remote, USA

    Remote, United States
    ... 's primary responsibility is supporting the daily claims process. Secondarily, they are responsible for ... LOB Supervisor Functions as a technical specialist for claims operations. Maintains a ...
  • Provider Network Operations Data Analyst Sr (hybrid)

    Manchester, New Hampshire
    ... initial submission to EO and claims post-production Capitation reconciliations – building queries ...
  • Special Investigator - Managed Care

    Remote, United States
    ... . Proactively performs research using the Internet, data analysis tools, etc., to analyze aberrant claims ... work experience preferred. Knowledge and proficiency in claims adjudication standards ...
  • Provider Network Account Executive II

    Washington, District Of Columbia
    ... including but not limited to, Claims Operations, Medical Management.Credentialing, Legal, Analytics ... include network management and networkrecruitment Extensive knowledge claims processing / billing ...
  • Manager Provider Network Management

    Dublin, Ohio
    ... implementation of electronic strategies for provider network to include increasing electronic claims submission and implementation of improved processes that result in increased auto-adjudication of claims ...
  • Coord Provider Network - Remote, Ohio Region

    Dublin, Ohio
    ... work experience in a Health Care field. 1 to 3 years relative experience in previous claims ...
  • Manager Provider Network Management

    Palm Beach Gardens, Florida
    ... claims submission and implementation of improved processes that result in increased auto-adjudication of claims. Recruitment: Responsible for compliance with State and accrediting agencies ...
  • Special Investigator Managed Care - DMV Counties only

    Washington, District Of Columbia
    ... . Proactively performs research using the Internet, data analysis tools, etc., to analyze aberrant claims ... preferred. Knowledge and proficiency in claims adjudication standards & procedures preferred ...
  • Provider Network Account Executive II

    Washington, District Of Columbia
    ... , Claims Operations, Medical Management. Credentialing, Legal, Analytics departments, Compliance, Sales ... Extensive knowledge claims processing / billing 5-10 years experience in the managed care/health ...
  • Financial Data & Reporting Analyst I--Managed Healthcare

    Harrisburg, Pennsylvania
    ... methodologies for tracking program trends and outcomes in a wide-variety of areas such as: claims, membership ...
  • Provider Network Account Executive II

    Charlotte, North Carolina
    ... Provider Network Account Executive II Location: Charlotte, NC Primary Job Function ...