ALL PAYER CLAIMS DATABASE jobs in USA, United Kingdom

health insurance claims information from all health care payers into a statewide information repository. Candidates local... years Medicaid System Design Technical Project management experience Experience with Healthcare Claims data and CMS...

JOIN TEAM TRILOGY Based in Louisville, Kentucky, our Home Office team is looking for a Payer Services Specialist... This role will report directly to our Director of Payer Relations and Auth Svcs. and is responsible for performing tasks related...

. Job Summary: The Payer Enrollment Manager will play a pivotal role in the implementation and management of a new claims...Payer Enrollment Manager Join Our Life-Saving Team in Phoenix, Arizona! Are you ready to elevate your career to new...

next-generation core administration and care coordination for transformative health plans. Within our Operations group, the Database... Administration team is responsible for maintaining and administering the relational database components of HealthEdge's award winning...

and/or a data integration project Healthcare experience (Payer or Provider) A plus to have a knowledge around Provider / Claims...Role: PLSQL Database Lead with Postgres Experience Location: NYC,NY Duration: Long Term Contract...

and/or a data integration project Healthcare experience (Payer or Provider) A plus to have knowledge around Provider / Claims...Position: PLSQL Database Lead with Postgres Experience Location: NYC, NY (Hybrid Model) Duration: Long Term Contract...

/Appeals, Claims Resolution, Trending Payer Issues Monday - Friday between the hours of 7am - 5pm AZ Time Within Banner..., payer contracts and federal regulations. We strive to create an environment that engages employees to produce at the highest...

I, Claims Processing (Lab) processes invoices received from hospitals/independent laboratories. This position ensures the... transaction level detail, approve line item for payment, or deny claims that are ineligible for payment and balance all amounts...

insurance benefit practices, preferred 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience 1-2... information or new information to be added to the database Conducts outbound correspondence when necessary to help support the...

. Experienced in query design/development (e.g. SAS, SQL, etc.) and/or relational database understanding Knowledge of Medicare..., reporting and requirements from either a payer or vendor a big plus Knowledge of and experience in Medicare and/or Medicaid...

relationships with, proactively educate, and ensure both providers and their staff are educated on payer and reimbursement policies... Markets, Trade & Distribution, Payer Values and Outcomes, and internal commercial teams to achieve targeted objectives...

). Experience: 5+ years of years of Medicare-related experience with payer, provider or value-based contracting. Excellent... with query tools, database platforms, data mapping/ETL, system platforms and software packages platforms (preferred) Experience...

of payers’ processes and updates and ensures that the physician database and NPPES system is kept accurate and current. CAQH re... of payer receipt date of the application). Assures that all contacts and discussion with payers are documented and maintained...

and resolving coding-related denials from A to Z, interpreting and applying payer guidelines, tracking and trending denial data... Specialist is responsible for resolving denied claims within the Charge Capture/Coding department under the direction of the...

coding and processing of inpatient claims. Clinical Document Improvement (CDI) Specialist Qualifications: 5+ years... necessity/appropriateness of clinical documentation. Ability to effectively communicate to the payer the medical necessity...

documentation thoroughly for any missing information or new information to be added to the database Conducts outbound... appropriate database for the inquiry Self-audit intake activities to ensure accuracy and efficiency for the program Make...

coding and processing of inpatient claims. Clinical Document Improvement (CDI) Specialist Qualifications: 5+ years... necessity/appropriateness of clinical documentation. Ability to effectively communicate to the payer the medical necessity...