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Results based on filters ( 138 jobs found )

Claims Coding Analyst

HealthFirst, Inc
Greenwood, IN
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The Claims Coding Analyst’s primary responsibilities require independent ...
Details
Summary
About the job:
judgement in making coding-based decisions on claims and appeals to maintain and enhance Healthfirst’s claims editing systems in ensuring proper claims payments, reviewing, researching, and responding to written and emailed correspondence from providers regarding claim denials, and acting as a subject matter expert handling more complex provider issues. They are involved in setting Healthfirst claims policy and ensure that Healthfirst payment policy is aligned with CMS (Centers for Medicare and Medicaid Services), New...
Location:
Greenwood, IN
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Six Figure Jobs (more than $100K)
From:
Built In
Certifications / Licenses:
ICD-10 / ICD-9
American Health Information Management Association
Accredited Management Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Coding Analyst

Healthfirst
New York, NY
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The Claims Coding Analyst’s primary responsibilities require independent ...
Details
Summary
About the job:
judgement in making coding-based decisions on claims and appeals to maintain and enhance Healthfirst’s claims editing systems in ensuring proper claims payments, reviewing, researching, and responding to written and emailed correspondence from providers regarding claim denials, and acting as a subject matter expert handling more complex provider issues. They are involved in setting Healthfirst claims policy and ensure that Healthfirst payment policy is aligned with CMS (Centers for Medicare and Medicaid Services), New...
Location:
New York, NY
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
Healthfirst
Certifications / Licenses:
ICD-10 / ICD-9
American Health Information Management Association
Accredited Management Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Project Planning & Operations Specialist

Healthfirst
New York, NY
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Reporting to the Director, the Specialist Sales & CE Ops Strategic Planning ...
Details
Summary
About the job:
& Performance will assist the Manager and Director for Sales & CE Ops Strategic Planning & Performance to execute, and continuously improve upon a retail strategy that supports the member and prospect experience, profitable growth across all product lines, and greater efficiency in operations across retail channels. This will include the day-to-day coordination of operations and retail strategic projects for the retail channel including community offices, mall kiosks, and other retail/sales sites. The Specialist will...
Location:
New York, NY
Job Type:
Full-Time
Permanent
Occupation:
Market Research Analysts and Marketing Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
Wyoming
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Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
Wyoming
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
New York
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Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
New York
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
New Hampshire
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Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
New Hampshire
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
Louisiana
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Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
Louisiana
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
North Dakota
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Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
North Dakota
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
Indiana
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Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
Indiana
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals and Grievances Clinical Specialist

Healthfirst
Oklahoma
Actions
Apply
Save to My Profile
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See who you know on LinkedIn
Report this job
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst ...
Details
Summary
About the job:
member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her...
Location:
Oklahoma
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Healthfirst
Certifications / Licenses:
Compliance Certification Management System
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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