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Description Humana has a new Claims Research & Resolution Supervisor opening for those in the Green Bay, WI and Louisville, KY areas. The Supervisor manages claims operations that involve customer contact, ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
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 Senior Market Development Professional provides support to assigned health plan(s) relative to Behavioral Health RFPs, product implementations and operational support. The Senior Market Development Professional work assignments involve moderately ..
Job Information Humana Senior Consumer Service Operations Analyst-Remote KY, IN or WI in Green Bay Wisconsin Description The Senior Consumer Service Operations Professional is responsible for the daily activities across multiple ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Green Bay Wisconsin Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ..
u003cpu003eThe Data Analyst Internship Program with WPS Health Solutions has 3 parts. First and foremost, you will get real world experience. No getting coffee here. Your role will make a difference ..
Description Responsibilities The Claims Quality Audit Professional 1 works with the Resolution Quality Audit leadership team to support efficiency and day to day operations. Requires in-depth knowledge of Microsoft products Excel, ..
Job Code 2168996I At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of ..
u003cpu003eu003cstrongu003eWho We Areu003c/strongu003eu003c/pu003enu003cpu003eu003ca href=u0022https://www.wpshealthsolutions.com/about/index.shtmlu0022 target=u0022_blanku0022 rel=u0022noopeneru0022u003eWPS Health Solutionsu003c/au003e is a leading not-for-profit health insurer in Wisconsin. Our services offer health insurance plans for individuals, families, seniors, and group plans for small ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eThe Prior Authorization Nurse Analyst is a work from home position that will assist in reviewing medical documentation for prior authorization requests submitted.u003c/pu003enu003cpu003eu003cstrongu003eIn this role you will:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003ePerform review of ..
Healthcare Data Analyst Salary: $80,000-$90,000/year, based on experience ... from disparate systems to generate claim submission data using continuous improvement ... to easily respond to insurance claim audits. Qualifications &..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
... 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 RN, Senior Stars Improvement, Clinical Professional in Green Bay Wisconsin Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ..
... Humana Lead Product Manager - Healthcare API in Green Bay Wisconsin ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
