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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 ..
Clinical Analyst The candidate will quickly and efficiently review medical records and submit well-written appeals to health insurers and governmental payers. Will navigate through various computer systems and applications to find ..
Business Analyst The candidate will quickly and efficiently review medical records and submit well-written appeals to health insurers and governmental payers. Will navigate through various computer systems and applications to find ..
... this role the Business Intelligence Analyst solves complex business problems and ... to decision-makers. The Business Intelligence Analyst work assignments are varied and ... well-being Responsibilities The Business Intelligence..
Description The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer ..
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 ..
Job Information Humana Senior Financial Analyst - Remote in Washington District ... vision is to improve member healthcare through innovative analytics and actionable ... is seeking a Senior Financial Analyst..
Job Information Humana Senior Process Improvement Professional/HGB (TRICARE Benefits, Claims processing exp.) Remote Nationwide in Washington District Of Columbia Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of ..
Job Information Humana Senior Risk Management Professional - Pharmacy claims in Washington District Of Columbia Description The Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. ..
... aspects related to reviewing pharmacy claim submissions for accuracy and appropriateness. ... tone and standard for pharmacy claim review. The Pharmacy Claims Professional ... pharmacies, make determination of appropriate..
... increasingly collaborative, and more efficient healthcare system! COVID Vaccination Requirements We ... an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations ... Equal Opportunity/Affirmative Action Statement Change..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Washington District Of Columbia Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of ..
... Humana Lead Product Manager - Healthcare API in Washington District Of ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Description The Business Intelligence 2 - Provider Intelligence and Claims Analytics (PICA) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The ..
Description The STARS Improvement Analyst develops, implements, and manages oversight ... and initiatives. The STARS Improvement Analyst work assignments are varied and ... well-being Responsibilities The STARS Improvement Analyst develops..
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 ..
Job Information Humana Senior Financial Analyst - Remote Nationwide in Washington ... Columbia Description The Senior Financial Analyst for Humana's Direct Contracting Entity, ... operational effectiveness. The Senior Financial Analyst..
Job Information Humana Pharmacy Claims Specialist, Remote in Washington District Of Columbia Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..
Description The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of ..
Description The Provider Insights & Claims Analytics (PICA) team is a blend of technology, data, and consulting professionals leveraging the latest tools and methods to solve complex business problems. In this ..
Description The Senior Business Intelligence Analyst (Claims Strategy) solves complex business ... decision-makers. The Senior Business Intelligence Analyst work assignments involve moderately complex ... In The Senior Business Intelligence Analyst..
