Senior Medical Director – Claims - Remote

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 Billing Specialist will maintain expertise in claims submission, accounts receivable management, interpretation of related practice documentation, · and other relevant tasks to support a best-in-class patient care platform. · ...

The Lead 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. · ...

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. · ...

+Do you have experience at a PBM? Navitus Health Solutions is seeking a Director, Technical Operations with no less than 5 years of experience at a PBM health plan or managed care environment to join our team This is not a call center or general operations leadership roles. · The ...

The Claims Manager will handle all insurance claim matters presented by clients of Risk Strategies Group and manage the operations/workflows of the Claims Department staff. · Setup and submit new claims to insurance carrier and place on follow-up activity diary review verify cove ...

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 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. · ...

The Project Manager contributes to the organization, operation... · ...

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. · ...

Assist the Director of HIM in preparing claim audits, reviewing and recommending coding, revenue cycle and charge/billing changes on client hospital outpatient and Profee claims using proprietary software product. · ...

Belle is seeking a Billing Manager to own end-to-end billing execution and revenue cycle performance. · ...

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 ...

The role applies advanced analytics, data engineering,& statistical modeling to large healthcare operational datasets to generate insights for organizational decision making. · Bachelor's degree or foreign degree equivalent in Computer Science, Data Analytics or related field and ...

The Senior Director, HEOR and Real World Evidence is a strategic leader responsible for the development and execution of HEOR strategies and evidence generation plans to demonstrate the value of Cristcot's products. · Advanced degree in an HEOR or related field (health services r ...

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. · ...

We're looking for an experience individual to join us as a Medical Billing Specialist. A Medical Biller for Home Health Services is responsible for accurately preparing, submitting, and following up on claims to insurance companies... · ...

The Billing · and Posting Resolution Advocate oversees claims production, billing follow-up collections compliance with third party payer regulations. This position manages process-based revenue cycle functions improving key revenue cycle indicators A/R days cash collection goal ...

The Research Medical Director is a key member of the Clinical and Policy research development area at Cotiviti. · Interpret and assess payment policy and medical coding information / guidelines against our policy library for maintenance of existing policy and development of new p ...

We are seeking an experienced Delivery Manager/Director to oversee the successful execution of Payment Integrity (PI) initiatives. This role will provide leadership across cross-functional teams ensuring timely delivery of solutions in areas such as DRG review Hospital Bill Audit ...

Our client, a leading real estate title services firm, is seeking a General Counsel. This role oversees all legal, regulatory and compliance matters. · ...