Sr. Facets Developer ApolisSr. Facets DeveloperBaltimore, MDRemote$60–$70 / hourRoles and responsibilities: Design and enhance Facets applications, provide SME leadership, develop SQL and. Collaborate with product management and stakeholders in an Agile environment to deliver technical solutions.
Data Analysis Consultant Ampcus IncorporatedData Analysis ConsultantColumbia, MD$70–$75 / hourThe Data Analysis Consultant leads the creation of cutting-edge analytic tools to drive better and faster decision making within the organization and provides critical support for key corporate programs, Medicare Advantage Stars and Risk Adjustment programs as it relates to provider data, provider to claims process. 50% Supports enterprise Stars and Risk adjustment strategy through collaboration with analysts, healthcare policy makers, and strategy leaders throughout the company to identify trends and opportunities across the Medicare and Medicaid healthcare landscape.
QA Engineer - DM platform (Remote) - Blue Bell, PA AHU TechnologiesQA Engineer - DM platform (Remote) - Blue Bell, PAWashington, District of ColumbiaRemoteThey are responsible for utilizing internal data sources to perform in-depth research and analysis on client data inquiries, execute a varying level of implementation functions such as testing new file extracts, provide defect and enhancement support to development and product teams. We are currently working on Various projects such as media entertainment, ERP Solutions, data warehousing, Web Applications, Telecommunications and medical to our clients all over the world.
Paralegal AmentumParalegalWashingtonIn accordance with the Health and Welfare provisions of the SCA, and in addition to your base hourly rate, you may be eligible to receive an additional health and welfare payment for each hour you work to ensure compliance with the minimums set forth by the act. Ensure all incoming correspondence reviewed for completeness ensuring file documents match claimant and Personally Identifiable Information (PII) compliance prior to CMS upload.
ParalegaI AmentumParalegaIWashingtonIn accordance with the Health and Welfare provisions of the SCA, and in addition to your base hourly rate, you may be eligible to receive an additional health and welfare payment for each hour you work to ensure compliance with the minimums set forth by the act. Ensure all incoming correspondence reviewed for completeness ensuring file documents match claimant and Personally Identifiable Information (PII) compliance prior to CMS upload.
Treatment plan coordinator/Front desk receptionist Lakeview Dental PcTreatment plan coordinator/Front desk receptionistWaldorf, MDFull timeAs the first point of contact, our Front Desk Receptionist plays a crucial role in ensuring a seamless and positive experience for every patient. We are a patient-centered dental office committed to providing high-quality care in a warm and professional setting.
General Clerk III ServiceSourceGeneral Clerk IIICapitol Heights, MDHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. This position completes routine enrollment tasks in support of the provider enrollment representatives and team; researches and controls incoming applications and correspondence to ensure the work is properly categorized; and reviews and processes a high volume of prospective provider enrollment applications.
Sr. Auto Appraiser - Field (Maryland) USAASr. Auto Appraiser - Field (Maryland)Baltimore Metro, Maryland$63,590–$121,530 / yearField Auto Appraiser, you will within defined guidelines and framework responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Supports workload surges and catastrophe (CAT) response operations as needed, including required on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
Sr. Instructional Designer Ampcus IncorporatedSr. Instructional DesignerWashington,, DC$50–$56.81 / hourESSENTIAL FUNCTIONS: 25% Designs, develops and delivers high quality Instructor-led, eLearning, and multimedia course materials including: course design documents, course outlines, course descriptions, presentation slides, diagrams, lab exercises, instructor guides, lab setup guides, job aids, and assessments. PURPOSE: Focuses on the systematic process employed to develop learning products for the organization through the analysis of learning/business needs, adult learning theory, partnering with subject matter experts, and the ongoing evaluation of programs to maintain accuracy and relevance.
Manager of Clinical Appeals and Grievances HealthfirstManager of Clinical Appeals and GrievancesMD$103,400–$149,430 / yearProvides guidance in the preparation of case preparation for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
Lead Project Manager (Training Lead) CACILead Project Manager (Training Lead)Washington, District of Columbia$94,400–$198,200 / yearBachelor’s degree in Training and Development, Education, Organizational Development, Business Administration, or a related field; 5+ years of progressive experience in training, learning and development, instructional design, or organizational change and leading, supervising, or managing a training team; Experience developing and implementing enterprise-level training programs and curricula, Ability to assess learning needs, identify knowledge gaps, and develop targeted training solutions; Experience designing and delivering initiatives; Excellent written, verbal, presentation, facilitation, and stakeholder-management skills. Job Title: Lead Project Manager (Training Lead)Job Category: TrainingTime Type: Full timeMinimum Clearance Required to Start: Public TrustEmployee Type: RegularPercentage of Travel Required: NoneType of Travel: None* * * The Opportunity The 9/11 Victim Compensation Fund (“VCF”) Team is engaging in a Transformation effort to optimize the processes and systems that support the 9/11 victims’ injury and loss claims.
Senior Test Automation Engineer Clearwaters.ITSenior Test Automation EngineerWashington, DCRemoteProficiency in defect tracking and test management tools (e.g., JIRA, TestRail, Bugzilla, HP ALM). Stay updated on emerging QA tools, trends, and methodologies, recommending new technologies and best practices.
PAR I & II TRC Talent SolutionsPAR I & IIWashington, DISTRICT OF COLUMBIAEnsures accurate and complete account follow-up by demonstrating a thorough understanding of carrier-specific reimbursement as applicable to claim processing to include: eligibility discrepancies, UB-04 and/or 1500 claims form review, DRG, per diem, case rate, fee schedule reimbursements, etc. Responsibilities: Performs second-tier account follow-up activities in accordance with organizational, client and regulatory guidelines for outstanding insurance receivables including, but not limited to: Performing account follow-up activities on high-dollar accounts receivable.
Customer Service Representative TRC Talent SolutionsCustomer Service RepresentativeWashington, DCTemporaryEnsures accurate and complete account follow-up by demonstrating a thorough understanding of carrier-specific reimbursement as applicable to claim processing to include: eligibility discrepancies, UB-04 and/or 1500 claims form review, DRG, per diem, case rate, fee schedule reimbursements, etc. Responsibilities: Performs second-tier account follow-up activities in accordance with organizational, client and regulatory guidelines for outstanding insurance receivables including, but not limited to: Performing account follow-up activities on high-dollar accounts receivable .
NewBilingual Chiropractic Assistant / Receptionist ARTISAN CHIROPRACTIC CLINIC LLCBilingual Chiropractic Assistant / ReceptionistHyattsville, MDFull timeIn addition, you’ll be hands-on in supporting patients through their treatments, which may include tasks such as taking vitals, guiding patients through therapeutic exercises, assisting with stretches, and setting patients up on therapy equipment like traction or muscle stimulation. Support daily clinic operations: Answer phone calls and emails, manage inventory and supplies, and help maintain clean, organized treatment rooms and waiting areas.
Area Sales Manager James Hardie Building Products IncArea Sales ManagerBaltimore, MD$80,000–$100,000 / yearThe Area Sales Manager is responsible for developing and maintaining relationships with distributors and dealers, generating awareness of, demand for, and sales of Versatex Trim and Siding products among builders, architects, remodelers, contractors/installers (i.e. end users) in their geographic area of responsibility. Keeps supervisor informed of key issues/changes occurring in assigned territory such as: competitor programs/products/actions, changes in dealers/distributors, dealer personnel, etc.
Coordinator 2 - Arbitration MaximusCoordinator 2 - ArbitrationBaltimore, MDFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net).
NewArea Sales Manager James HardieArea Sales ManagerBaltimore, MD$80,000–$100,000 / yearThe Area Sales Manager is responsible for developing and maintaining relationships with distributors and dealers, generating awareness of, demand for, and sales of Versatex Trim and Siding products among builders, architects, remodelers, contractors/installers (i.e. end users) in their geographic area of responsibility. Keeps supervisor informed of key issues/changes occurring in assigned territory such as: competitor programs/products/actions, changes in dealers/distributors, dealer personnel, etc.
Market Conduct Examiner (Health and PBM) RSMMarket Conduct Examiner (Health and PBM)MarylandThe Market Conduct Examiner will be responsible for performing reviews of major insurance companies’ operations, marketing, underwriting, mental health parity quantitative and non-quantitative treatment limits, pharmacy benefit management practices, rating, policyholder service, producer licensing, complaint handling and claims handling processes to verify compliance with states’ insurance statutes and regulations. This includes, but is not limited to, analyzing compliance pertaining to review of pharmacy audits conducted by PBMs, spread pricing, pharmacy reimbursement, dispensing fee requirements, annual reports, contract review, financial review, internal and external appeals, claims processing, and network adequacy.
Payment and Medical Policy Coordinator (Remote) Blue Cross and Blue Shield AssociationPayment and Medical Policy Coordinator (Remote)DCRemote$51,264–$101,816 / yearThis role ensures business readiness across impacted functions, including claims, configuration, provider communications and operations, and provides support during testing, implementation, and post-implementation validation. QUALIFICATIONS: Education Level: Bachelor''s Degree in Health Administration, Business, Finance or related discipline OR in lieu of a Bachelor''s degree, an additional 4 years of relevant work experience is required in addition to the required work experience.