Healthcare Claim Analyst Jobs

The healthcare consultant will perform the following responsibilities: Conduct analysis of health plan and provider functional areas to identify impacts, opportunities and risks related to the implementation of ICD-10, create high ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Washington District Of Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, ..

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 Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..

Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..