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HourlyPosition Purpose: Run,analyze,and audit batch reports to ensure accuracy of claims data. Review claims for adjudication,adjustment,billing,coding,compliance and reimbursement. Run,analyze,and audit batch reports to ensure accuracy of claims data Review,investigate,adjust ..
Job Description Performs functions relative to denial management. Compiles and provides Management with denial reports and evaluates trending. Assist with providing feedback to departments on cause and effect of ..
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 ..
... documentation to determine if an appeal is warranted. The Grievances & ... & Appeals Professional 1 receives appeal requests from both members and ... ensures the requests meet specific..
Title: Part D Medical DirectorLocation: Work from Home in any U.S. StateSchedule: 8:00-5:00 ETWeekend Coverage: Every 8th weekend with a day off the following weekHolidays: We cover holidays on a ..