together. No industry is moving faster than health care. And no organization is better positioned to lead health care... performance targets for the enterprise. As a subject matter expert, you will interpret and analyze claims and non claims data...
provider performance, and access Lead out on several projects that are key to the success of the network, working... Qualifications: 2+ years of experience with claims processing systems and provider databases as well as claims system testing...
and Broker to effectively administer claims. Establish and lead periodic claim reviews. Arrange/update/customize special... course of action to appropriately manage and settle the claims. Monitor claims consistent with corporate policies...
Job Description: Your Role The Facility Compliance Review team reviews post service prepayment facility claims... Certified Clinical Coder Nurse, Lead/Consultant will report to the Senior Manager, Facility Compliance Review. In this role...
. Responsibilities: May serve as project lead for implementation of products and services. Analyze the performance of the product.... Work with partners in pricing/actuarial or claims to ensure product compliance and financial viability. Prepare contract...
(i.e., patient access, patient accounting, claims clearinghouse, eligibility, etc.). Tasks are performed under the direction of lead..., heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped...
Job (Key responsibilities) · Lead in the advancement of data-driven market access strategies as a strategic partner to Market... and lead communications related to IQVIA and pharmacy-related reporting and support · Perform 340B trend analysis...
Healthcare Management's P&L evaluation on routine basis that lead to key medical cost savings action plans. Key focus areas..., systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting...
with payer requirements, to identify third party monies available through claims or settlement mechanisms. 4. Coordinates data... improvement such as analyzing Return to Providers (RTPs) or work queues. Lead department teams to implement changes, creating work...
experience who will take the lead on various projects to help solve business problems. Integral to this role will be the... interaction with underwriters, claims personnel, finance, and other members of the actuarial, risk management, and catastrophe...
role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical... across the enterprise to lead clinical performance analytics, development, and reporting that deliver actionable clinical...
timely submission of primary, secondary and tertiary insurance claims. Serve as a subject matter expert for close Review... and approve adjustments and claims appeals submitted by Specialist of Patient Accounts Conduct quality assurance reviews of work...
to accomplish project goals in a timely manner. Develop specifications for Information Technology partners May participate or lead... and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims...
strong internal and external partnerships. The Specialist will be responsible for researching and processing customer financial claims.... Co-lead the execution of annual price increases/decreases, including notifications, timing, and implementation strategies...
role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical... across the enterprise to lead clinical performance analytics, development, and reporting that deliver actionable clinical...
prospective cohort studies, claims, charge master and EHR in collaboration with RWE TA lead. Understand methods and programming... value of the client's therapies using RWD (e.g. claims and EHR). QC programming for descriptive and complex studies using...
(day to day) strategic sourcing strategy and execution for your categories under the supervision of sourcing lead... in a sustainable and ethical manner. · Category Strategy – in conjunction with Sourcing Lead, develop annual category segment...
prospective cohort studies, claims, charge master and EHR in collaboration with RWE TA lead. Understand methods and programming... value of the client's therapies using RWD (e.g. claims and EHR). QC programming for descriptive and complex studies using...
, we’re looking for unique voices to help lead us forward. If you’re ready to challenge your limits and build your future... discrepancies. Resolve claims issued by brokers and custodians. Monitor and resolve failed trades. What we're...
Financial Services staff for reporting problems and denials on individual claims. Assist in researching coding issues, provide... and denials will include areas from Hospital, Physician and Home Health. Lead and participate in projects related to Revenue...