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Description Account Reconciliation Specialist is responsible for processing explanation of benefits (EOB), electronic fund transfers (EFT) and remittance codes applying cash via individual receipt into the patient and division accounting systems, ..
Description Humana is looking for someone to help continue the successful of a new program providing outright to our Medicare members in New York City. The Medicare Membership Retention Specialist is ..
Job DescriptionnnAttention NJ Applicants: In April 2020, our Company announced plans to consolidate our New Jersey campuses into a single New Jersey headquarters location in Rahway, NJ by 2023. Therefore, the ..
#LI-Remote Citeline is one of the world's leading providers of data and intelligence on clinical trials, drug treatments, medical devices and what's new in the regulatory and commercial landscape. Relying on ..
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. ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in New York New York Description The Fraud and Waste Professional 2 conducts investigations of ..
ROLE SUMMARYThe Director, Oncology, I&I, Biosimilars Public Affairs reports to the Vice-President, Public Affairs & Policy (Oncology, Inflammation & Immunology, Rare Disease, Internal Medicine). They lead the development and management of ..
Description The Medical Records Retrieval Representative works with regional providers in Downstate NY to utilize EMR access and other retrieval methods to retrieve member medical records that will be submitted to ..
... 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 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 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 ..
Clinical Outcome Assessment (COA) Specialist is responsible for working directly with COA Manager to provide technical and general administrative support for assigned eCOA studies including but not limited to; managing and ..
... 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 Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Jersey City New Jersey Description The Fraud and Waste Professional 2 conducts investigations of ..
Job Information Humana Senior Integration Specialist - Cloud in Jersey City New Jersey Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Investigative Site Budgets Specialist (Sr. Manager) The candidate will ensure compliance with Pfizer SOP and any laws or regulations regarding investigator and clinical trial site compensation. Support site contracting professional and ..
We are looking for an entrepreneurial self-starter for the role of A/R & A/P Specialist to assist in the day-to-day operations of the finance team, including invoicing & collections, customer relations, ..
Why Patients Need YouPfizer Worldwide Medical and Safety colleagues play a key role in connecting evidenced based, medical decision support with colleagues and stakeholders to enable better health and treatment outcomes. ..
... 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 Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Livingston New Jersey Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
Interested in Product but don’t know how to start? Come join Cedar as an Associate Product Manager! This role has been designed for candidates that are looking for the opportunity to ..