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Claims Validation Jobs

54 jobs

DUTIES The Claims Validation Analyst will work within the claims department to ensure the correct configuration and functioning of the L.A. Care Health Plan primary claims processing systems. The Analyst performs technical and analytical work to support the functional and reporting requirements of the Claims unit. The Validation Analyst will consult and collaborate with Claims Department supervis...
DUTIES The Claims Validation Analyst will work within the claims department to ensure the correct configuration and functioning of the L.A. Care Health Plan primary claims processing systems. The Analyst performs technical and analytical work to support the functional and reporting requirements of the Claims unit. The Validation Analyst will consult and collaborate with Claims Department supervis...
Description: UnitedHealthcare Medicare & Retirement Pharmacy Services Management is searching for an expert problem-solver with experience in implementing and managing quality end-to-end business processes to join our Medicare Part D team as a Part D Readiness and Validation Manager. The Part D Readiness and Validation Manager will be overseeing and managing all Pharmacy claim level review and m...
Description: UnitedHealthcare Medicare & Retirement Pharmacy Services Management is searching for an expert problem-solver with experience in implementing and managing quality end-to-end business processes to join our Medicare Part D team as a Part D Readiness and Validation Manager. The Part D Readiness and Validation Manager will be overseeing and managing all Pharmacy claim level review and m...
Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.(sm)Responsible for the maintenance, processing, reporting, distribution, and reconciliation of monthly PCP capitation an...
Job DescriptionQUALITY ASSURANCE MANAGER Quick Job Summary: - Oversee Quality Control of facility - Prior QC experience preferred in the pulp and paper industry, but can be in food industry - Perform QC test and oversee other tests that are being run Essential Functions: - Oversees continuous process, procedural and product improvement related to quality assurance - Formulates, documents and maint...
The Used Vehicle Warranty Service Coordinator will administer extended warranty coverage to approximately half of the 12,000 retail used vehicles Ryder sells annually. It is anticipated 6,000 vehicles will be under coverage at any given time. The Used Vehicle Warranty Service Coordinator will use customer service skills, administrative abilities, Ryder's business rules, mechanical knowledge, failu...
The Used Vehicle Warranty Service Coordinator will administer extended warranty coverage to approximately half of the 12,000 retail used vehicles Ryder sells annually. It is anticipated 6,000 vehicles will be under coverage at any given time. The Used Vehicle Warranty Service Coordinator will use customer service skills, administrative abilities, Ryder's business rules, mechanical knowledge, failu...
We believe work is not a place, but rather a thing you do. Our technology revolves around this core philosophy. We are relentlessly committed to helping people work and play from anywhere, on any device. Innovation, creativity and a passion for ever-improving performance drive our company and our people forward. We empower the original mobile device: YOU! Location: Fort Lauderdale Requisition: ...
Warranty and Reliability Manager Position Summary The Warranty and Reliability Manager provides leadership in coordinating warranty trend summaries along with input on continuous improvement actions. This individual coordinates activities and drives changes to reduce Warranty costs and provides warranty oversite through efficient Warranty Claim Validation, Warranty Data Mining and Statistical An...
Capitation Specialist I - Irvine, CA-667956 Description Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.(sm) Responsible for the maintenance, processing, reporting, distribution, a...
Program Integrity Analyst - 115953 Reporting & Data Analysis-670011 Primary Location :VA-Norfolk Other Locations :CA-Woodland Hills, CA-Thousand Oaks, IL-Chicago, VA-Virginia Beach Description Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health fo...
JOB SUMMARY : Validate and correct billing information prior to claim dropping. Send corrections done to registration coordinator and other billing department within the facility Do charge corrections received from Medical Records or other departments in hospital, Put comments in what was changed and who asked for the change Add observation charges hours given by authorization team or Medical R...
Our finance professionals at UnitedHealth Group are engaged in the important work of making health care more affordable, simpler and easier for people to access. Now, more than ever we need finance and accounting professionals like you with the financial skills and discipline to help us achieve this goal. As a Senior Financial Analyst you'll impact millions of lives. You will collaborate with an e...
Our finance professionals at UnitedHealth Group are engaged in the important work of making health care more affordable, simpler and easier for people to access. Now, more than ever we need finance and accounting professionals like you with the financial skills and discipline to help us achieve this goal. As a Senior Financial Analyst you'll impact millions of lives. You will collaborate with an e...
Job Description: Essential Job Functions and Responsibilities include but not limited to: Manage account relationships as the primary point-of-contact for day-to-day needs, including ongoing communications, freight, billing, collections and other activities on a proactive basis Review and process Claims. Validate and issue RMA (Return Merchandise Authorization) on request, collaborate with wareho...
Description Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one...
Description Summary: The Billing Reimbursement Lead provides the necessary leadership, mentoring, and training of Diplomat’s Medical Billing team. This position is responsible for leading the billing team in filing and tracking insurance and funding claims, validating correct payments as well as working aged accounts receivable (AR). Duties and Responsibilities include the following. Other duti...
Warranty and Reliability Manager Position Summary The Warranty and Reliability Manager provides leadership in coordinating warranty trend summaries along with input on continuous improvement actions. This individual coordinates activities and drives changes to reduce Warranty costs and provides warranty oversite through efficient Warranty Claim Validation, Warranty Data Mining and Statistical An...
Are you an experienced Senior Consultant with a background supporting health and human services program integrity initiatives, including Medicare/Medicaid Fraud? Let’s talk. As a professional in the government consulting field, you understand how to effectively support states undertaking expansive IT development and implementation projects. First Data Government Solutions is seeking a Program I...