that balance member advocacy, plan integrity, and regulatory requirements. Advanced Investigation & Root Cause Analysis... · Ensure that comprehensive investigative reviews are conducted across claims adjudication, eligibility, benefit interpretation...
of claims, billing, enrollment, and care management workflows, particularly in Medicaid and Medicare segments. Knowledge.... Ability to balance competing priorities and align work with organizational capacity. Strong analytical and problem-solving...
diagnostic (CDx) claims to existing products. The Project Manager works closely with program managers and other team members... to influence across multiple business functions and organization levels to balance complex priorities and competing stakeholder...
, and testing of PBM-related claims and benefit coding changes. Key priorities include finding candidates with PBM and healthcare... claims experience, strong analytical and Excel-based technical skills, and the ability to work efficiently in a high-volume...
, and in a timely manner in order to maintain accurate available stock balance;ensures that monthly reconciling items are resolved... timely, completely and accurately;bills or credits all assigned shipper loads as appropriate;processes claims for returned...
claims and correcting journal entries) prior to posting entry into the accounting system. Ensure that all balance sheet... transactions (payment vouchers, receipt vouchers, debit and credit notes, staff time charges, expense claims, credit card expense...
, and in a timely manner in order to maintain accurate available stock balance;ensures that monthly reconciling items are resolved... timely, completely and accurately;bills or credits all assigned shipper loads as appropriate;processes claims for returned...
Representative maintains up-to-date patient information, assists with medical claims, and uses management information systems... their questions, concerns, and needs during refill scheduling. Run medical claims and document concise, accurate progress notes...
JobsRUs.com is seeking to hire an Electronic Data Interchange Claims Filing Specialist for our client in Brentwood, TN... Job Description The Electronic Data Interchange (EDI) Claims Filing Specialist is responsible for ensuring claims are successfully...
Representative maintains up-to-date patient information, assists with medical claims, and uses management information systems... their questions, concerns, and needs during refill scheduling. Run medical claims and document concise, accurate progress notes...