Claims Professional I Jobs in Troy

Description The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly ..

Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..

Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..

Description This Actuarial Analyst 2 role on the Specialty Benefits team will take ownership of our Dental and Vision commercial group (100 lives) renewal reporting and the dental trend analysis. This ..

Description The Senior Pharmacy Claims Professional oversees processes and ensures accuracy ... coordination of benefits (COB) adjudicated claims. The Senior Pharmacy Claims Professional work assignments involve moderately complex ... factors...

Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management ... errors. The Health Information Management Professional work assignments are varied and ... Responsibilities..

Description The Senior Health Information Management Professional work assignments involve moderately complex to complex issues to work with various teams to develop business requirements, track and monitor the success of the ..

Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..

Description The Claims Review Representative 3 makes appropriate ... based on strong knowledge of claims procedures, contract provisions, and state ... state and federal legislation. The Claims Review Representative 3..

Description The Pharmacy Claims Professional 2 monitors and ensures appropriate ... ensures appropriate adjudication of pharmacy claims. The Pharmacy Claims Professional 2 work assignments are varied ... of action. Responsibilities..

Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..

Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..

Description The Pharmacy Claims Professional 2 is responsible for the ... maintaining guidelines. Responsibilities The Pharmacy Claims Professional 2 analyzes and answers inquiries ... and answers inquiries regarding pharmacy claims..

Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..

... Information Humana Pharmacy Desktop Auditor (Claims Professional 2) in Troy Michigan Description ... pharmacy claim review. The Pharmacy Claims Professional 2 work assignments are varied ... education and experience..