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Consumer Complaints/AGO Help Center Case Management SystemSQL Server to Microsoft Dynamics 365/CRM leveraging SQL Server (Kingsway Soft SSIS)I. Leveraging Kingsway Soft’s SSIS Integration Toolkit (preferred to have experience with this tool, but not required)Missing Children’s Clearing House (MCCH)Oracle 10gto SQL ServerMental Illness Adjudication Reporting (MIAR)SQL Server to SQL ServerSkills needed include.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Oversee accurate calculations and reporting of Average Manufacturer Price (AMP), Average Selling Price (ASP), Best Price (BP), and Non-Federal AMP (NFAMP) and 340B pricing to the appropriate regulatory entities for all Company and affiliate labeler codes.
Full-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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This position is accountable for reporting of project progress status to Everest internal management and its clients, for activities including, but not limited to site selection, study start-up, clinical operations, statistics, data management, subject randomization and drug supply management (Interactive Web Response Systems [IWRS]), data monitoring and/or adjudication committees, regulatory submissions, vendor management, and medical/scientific writing.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Intermediate to advanced understanding of pharmacy technology - included is product dispensing, data entry, and adjudication workflow steps. + Assists the supervising pharmacist with monitoring and reporting quality assurance events.
$20 - $23 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Familiar with various analytical or reporting tools, such as SAS, R, Matlab Tableau, etc. The Credit Risk Manager I manages the creation, implementation and validation of various risk segmentation strategies including, but not limited to: adjudication, account management, exposure management, risk segmentation, and financial return optimization.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process. Develop and provide KPI reporting for the Patient Advocacy department to management.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Healthcare industry experience as it relates to risk adjustment, medical claims submissions, adjudication and payment, eligibility, encounters file management in particular for Medicaid/Medicare populations.
Full-timeExpandApply NowActive JobUpdated 17 days ago - UpvoteDownvoteShare Job
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The Claims Examiner II is responsible for the adjudication of healthcare claims utilizing specific policies and procedures. The Claims Examiner II is accountable for reviewing the adjudication system edits to determine whether to pay the claim and/or line item(s.
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PRIMARY PURPOSE OF THE ROLE: To analyze high-level Commercial General Liability / Bodily Injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
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Preferred Qualifications- Experience in healthcare fraud, waste and abuse- Experience with Medicaid and/or Medicaid healthcare claims data and regulatory reporting- Knowledge of healthcare claims adjudication- 2+ years of demonstrated leadership.
RemoteExpandUpdated 6 days ago - UpvoteDownvoteShare Job
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Basic Information Security, Department of Defense Personnel Security Adjudicator Course, Marking Classified Information, Derivative Classification Course, and Personnel Security for Customized Adjudication.
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The Risk Manager I manages the creation, implementation and validation of various risk segmentation strategies including, but not limited to: adjudication, account management, exposure management, risk segmentation, and financial return optimization.
Full-timeExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
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What You’ll Get to Do:Prepare and submit a JTF-GTMO Physical Security SOP.Provide support to the Command Security Manager in implementing JTF-GTMO physical security operations in accordance with JTF-GTMO Physical Security SOP.Coordinate Physical Security Assessments (PSA) of all buildings and workspaces under JTF-GTMO control and provide recommendations to ensure compliance with command and DoD physical security policies, procedures, and reporting.
Full-timeExpandUpdated 6 days ago - UpvoteDownvoteShare Job
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Expertly use our Applicant Tracking System, Workday, to ensure data integrity and reporting accuracy. preference within high growth Fintech and/or healthcare. Partner with key internal stakeholders, including our People & Culture Business Partners, Talent Acquisition Operations, Total Rewards, and Finance.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care.
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