Directly report to and support the Program Manager by overseeing a team of claims processing automation analysts in the successful delivery of services across all assigned task areas including, but not limited to, automation review, claims processing, and quality assurance. Participate in scheduled calls with the customers, partners, and vendors. Continually assess operat

The Superior Court of California, County of San Bernardino, seeks qualified and motivated research attorneys experienced in civil law/civil litigation to join our Legal Research Department as a Judicial Staff Counsel III . SALARY UPDATE Effective October 2024, a 3% COLA increase; approximate annual salary $127, 381 $163,016. Benefit Information VIEW THE 2024 BENEFITS GUID

Contacts insurance carriers / patients regarding outstanding insurance claims to obtain proper payment based on EOB and / or Experian contract modeling expectations. Knowledge of clinic operating policies to help in the identification of denial root causes. Prepares proper documentation for appeals to insurance carriers. Processes the appealing of claims reimbursed incorr

Assist in end to end provider claims and help enhance provider experience Assist in efforts to enhance ease of use of provider portal and future services enhancements Support development and management of provider networks within assigned regions Help implement training and development of external providers through education programs in collaboration with our training tea

Serve as primary contact as it relates to all enrollment tasks for assigned book of business, which include multiple group customers; maintain satisfied customers by providing superior service and practice attention to detail in various responsibilities. Answer member, provider, and group customer phone calls; adhering to department expectations for answering calls and pr

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, c

Critical performance responsibilities Compiles and maintains accurate and timely information on contract performance for all fee for service and value based contracts in a database, including renewal dates, cancelation notices and provider relations contacts Assist in the development of a fee for service and value based contracting strategy for Medicare, Commercial and Me

Manage unit cost budgets, target setting, performance reporting and associated financial models Predict emerging customer needs and develop innovative solutions to meet them Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Evaluate and negotiate contracts in compliance with compan

Lead and perform financial analysis and modeling as it relates to setting prescription drug prices Create and/or execute pricing models, complex analysis and reports Concisely summarize and communicate the results of complex analytics Lead projects to completion by contributing to database creation, statistical modeling and financial reports Predict emerging customer need

Administration of Pension Benefits Collection of data from pension participants to determine eligibility and vesting schedule. Answer questions via telephone and email to convey information regarding the provisions of the pension plans. Create various types of members or employer correspondence including letters and emails. Collection and data entry of participant hours w

Extract, analyze, aggregate, review, and interpret data Participate in client communications and build sustainable client relationships Prepare information for clients by building reports and delivering summary of results Collaborate and communicate effectively with broader team, while supporting ad hoc analytics where needed Serve as a resource to others and develop stra

Welcome and thank you for your interest in employment with Loudoun County Government! ALL SECTIONS OF THE APPLICATION MUST BE COMPLETED IN ITS ENTIRETY. THE RESUME IS CONSIDERED SUPPLEMENTAL INFORMATION ONLY. APPLICATIONS THAT ARE INCOMPLETE OR INDICATE 'SEE RESUME' WILL NOT BE TAKEN INTO CONSIDERATION. Job Summary The Loudoun County Attorney's Office is seeking a Senior

Welcome and thank you for your interest in employment with Loudoun County Government! ALL SECTIONS OF THE APPLICATION MUST BE COMPLETED IN ITS ENTIRETY. THE RESUME IS CONSIDERED SUPPLEMENTAL INFORMATION ONLY. APPLICATIONS THAT ARE INCOMPLETE OR INDICATE 'SEE RESUME' WILL NOT BE TAKEN INTO CONSIDERATION. Job Summary Loudoun County is seeking an attorney who will primarily

The Medical Billing Payor Verification for Government Payors will work with payor portals and payors via telephone communications to verify benefits, deductible and out of pocket amounts, primary, secondary, and tertiary payors. Problem solve and research and resolve coordination of benefits issues. Work as a team to meet team goals and deadlines. HOURS/WORK SCHEDULE Trai

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here. Applicants must be eligible to begin work on the date of hire. Applicants must be currently authorized to work in the United States on a full time basis. ARKANSAS BLUE CROSS BLUE SHIELD will NOT sponsor applicants for work visas in this position. Arkansas Blue Cross is only seeking