Healthcare Payment Specialists Jobs in Green Bay

Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..

Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Green Bay Wisconsin Description The Fraud and Waste Professional 2 conducts investigations of allegations ..

Job Information Humana FP&A Lead, Medicaid Market in Green Bay Wisconsin Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

Job Information Humana Senior Integration Specialist - Cloud in Green Bay Wisconsin Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing between ..

Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..

Job Information Humana Compliance Professional 2 - Medicaid in Green Bay Wisconsin Description Responsibilities Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. ..

Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..

Description The UM Compliance Letters Specialist/Coordinator 2 contributes to administration of utilization management in the Compliance department. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. ..

Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..

Description The Clinical Applications Trainer (aka Senior Technology Sales Professional) promotes and sells a portfolio of technical products and/or services and solutions directly to current and new end customers. The Senior ..

Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..

Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..

... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Green Bay Wisconsin Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..

Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..

... Qualifications Minimum 5 years of healthcare fraud investigations and/or auditing experience ... of Florida and Wisconsin Medicaid healthcare payment methodologies Strong organizational, interpersonal, and ... the required qualifications. Understanding..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

The Pre-Verification Specialist provides assistance to the Practice Site by working with patients, insurers, and providers. Ensures that necessary requirements are met in order to receive authorization that payment will be ..

Description The Site Reliability Engineering (SRE) Lead Technology Leadership Professional - Pharmacy Dispensing Solutions is responsible for all aspects of the production environment support strategy, Operational Excellence strategy and execution, and ..

Description Humana's Corporate Marketing organization is seeking a seasoned communications expert to join our Internal Communications Team, supporting the transformation of Humana's core insurance technology systems and operating model - known ..