- AIG (San Francisco, CA)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within ... an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability...+ 7+ years of medical malpractice / professional liability complex claims and/or complex litigation… more
- Banner Health (Phoenix, AZ)
- …effectiveness of risk mitigation strategies. 9. Oversight for investigation and evaluation of complex claims and manages such claims through mediation and/or ... Claims Mgmt **Work Shift:** Day **Job Category:** Legal The **Executive Director , Claims & Litigation Counsel** will provide strategic and operational… more
- Humana (Little Rock, AR)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Whitney Young Health Center (Albany, NY)
- …for reviewing medical claims prior to submission and following up on more complex or problem claims or insurance types as designated by the Director ... date . Four (4) years of progressive experience in medical billing and claims processing in a multi-specialty healthcare setting. Professional coding experience… more
- CommuniCare Health Services Corporate (Charleston, WV)
- …leader in post-acute care for those that are chronically ill or have complex conditions. Our more than 150 skilled nursing, assisted living, independent living, ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...team, CBO cash posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management, and others. The… more
- Molina Healthcare (OH)
- …Summary** Support the Market CFO in Wisconsin FP&A. Performs research and analysis of complex healthcare claims data, and utilization management data for ... needs. Evaluates data, writes code, creates dashboard tools, and presents healthcare utilization and cost containment reports across Medicaid, LTSS, Medicare, and… more
- VNS Health (Manhattan, NY)
- OverviewManages the configuration and maintenance of the claims system used to administer operations of current and new business for VNS Health Plan products. ... reports, recommendations, and updates/revisions to address existing and potential claims system issues. Works under general direction. Compensation Range:$98,200.00… more
- Prime Healthcare (Farmers Branch, TX)
- …trends and identify opportunities for process improvement and reimbursement optimization. + Complex Claims Management: identifies, trends, and owns portfolios of ... Outsourcing program across Revenue Cycle Management for all Prime Healthcare . The Corporate Director is responsible for... complex claims , including Third party claims , TDRG, Zero… more
- City of New York (New York, NY)
- … Director of OHSSA. This position will also serve as the inaugural Director of Healthcare Accountability, leading strategy and implementation for Local Law ... the Agency's Chief Medical Officer. The BEHS is the healthcare systems bureau of DOHMH. Our mission is to...routinely update their interpretation in accordance with a highly complex , rapidly evolving regulatory environment. - Stay informed of… more
- Prime Healthcare (Ontario, CA)
- …including Claims and Customer Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals. + Integrates and coordinates services using ... and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical-utilization-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management… more