Senior Medical Director – Claims - Remote

The Director, Claims provides strategic and operational Claim leadership for the assigned territory, including the execution of industry best practices for claims handling and all related case management. The Director assures claim performance is sound both technically and financ ...

The Director, Claims Configuration ensures that plans, benefits, · and all aspects of payment logic are accurately translated into the claims systems to support · compliant, efficient and high-quality claims adjudication This leader partners closely with · Claims Operations Optim ...

The Claim Consultant provides complete claim loss services for policyholders. This role will investigate, evaluate and dispose of legal malpractice claims with varying degrees of complexity and severity. The Claim Consultant works independently to provide claim-loss service for C ...

The Billing Specialist (Biller) is responsible for the performance of a broad range of billing activities related to processing of claims for physician and practice-related ancillary services. The Billing Specialist will maintain expertise in claims submission, accounts receivabl ...

· Company · Navitus · About Us · Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the peo ...

We truly believe we are building something special – a robust suite of cost containment solutions – through additional hires and expansions and additions in product offerings as we grow within the claims re-pricing ecosystem and across cost containment adjacencies. · ...

· Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client's needs, providing everything from individual specialty claims repricing, to full ...

The Project Manager 2 contributes to the organization and operation of the State of Rhode Island's Office of Data, Analytics and Evaluation (ODAE) including its work with Medicaid Ecosystem and All-Payer Claims Database data systems. · ...

Position Summary: · The Collections and Payments Specialist is responsible for the performance of a broad range of collection activities related to obtaining payment for past due health insurance claims. The Collections and Payments Specialist will maintain expertise in organizat ...

About Us: · Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keep ...

WHO WE ARE · Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environmen ...

· About Us · Please note: This is a hybrid position, with remote work 90% of the time. However, the role requires an in-person commute to the office in The Woodlands, TX once a month for meetings. · We are Emerus, the leader in small-format hospitals. We partner with respected a ...

If you're passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty ...

The Lead Medical Coding Specialist works in conjunction with the Coding Supervisor to ensure accuracy, consistency and efficiency in relation to code assignment for reimbursement and reporting purposes. This position is a working Lead position and is expected to work alongside st ...

About the role · Position Overview: · We are seeking a dynamic Director of Business Development with a deep understanding of healthcare revenue cycle management. This role involves identifying and securing new business opportunities, building strong client relationships, and driv ...

· Company Description · Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value ...

POSITION SUMMARY · The Director of Safety is responsible for leading the enterprise-wide safety and risk management strategy across all company locations. This executive-level position provides strategic oversight of occupational safety, regulatory compliance, fleet safety, claim ...

· Overview · The Medical Director (MD) is a key member of the audit, quality assurance and client team. The Medical Director is responsible for representing the team on all audit and appeals decisions. The Medical Director is also responsible for analyzing, interpreting, and dev ...

· "Mineralys Therapeutics is a clinical-stage biopharmaceutical company focused on developing medicines to target hypertension and related comorbidities such as chronic kidney disease (CKD), obstructive sleep apnea (OSA) and other diseases driven by dysregulated aldosterone. Its ...

The company is looking for an Engineering Manager to lead their team of engineers. The manager will be responsible for coaching and mentoring engineers, providing technical guidance and oversight for event-driven systems, collaborating with product managers to define roadmaps. · ...

Assured is on a mission to modernize insurance. Claims processing (i.e. should we pay this claim?), while often overlooked, is the foundation of the entire industry. It's currently highly manual, involving phone calls, faxes, and gut instinct, costing tens of billions of dollars ...