PROVIDER NETWORK OPERATIONS CLAIMS jobs in UNITED STATES, United Kingdom

. Discover more about us at www.amerihealthcaritas.com. The Provider Network Operations Data Analyst Senior supports the... business goals and initiatives of the Provider Network Operations department. This role is responsible for: UAT/Client Review...

Summary of Position Serve as the key operational liaison with Provider Network Management and Finance: responsible... to monitor performance. Drive discussions directly with all Provider back office operations to resolve claim processing disputes...

, including interpreting clinical outcomes, claims data, and trends to understand provider network utilization and cost trends... about life at Wellmark . Job Description About the opportunity: Wellmark’s Director of Provider Network Development...

Responsibilities Provides superior service to all network providers, assisting with resolution of provider issues regarding claims...Overview Now hiring a Provider Network Management Relations Service Associate Primarily responsible for supporting...

of provider contracts, claims payments, provider set up, and root cause analysis. A key to success will be someone who... signatures, preparing provider rosters, submitting contract load form Assistance with Field Network cases, outreach...

the network team in preparing for monthly IPA meetings. The ideal candidate will also have knowledge of provider contracts..., claims payments, provider set up, and root cause analysis. A key to success will be someone who has exhibited a proven...

of electronic strategies for provider network to include increasing electronic claims submission and implementation of improved... is also responsible for all provider network recruiting and contracting management activities. Ensures that the department and staff...

operations within Networks, Credentialing and Contracting Departments. It is expected of the employee to develop, implement... and maintain an accurate provider data base; analyze provider data, facilitate the preparation and follow-up of the monthly...

audits for network operations, and claim testing for PPO Network creation. Fundamental Components & Physical Requirements... to business partners (*) Assist with the day-to-day maintenance and operations of assigned functional unit (*) Perform...

of and experience with MA PPO and CMS Reimbursement regulations and Methodologies. Ability to Partner with Claims Operations, claim BPO... complex claims inquiries received from though-out the organization, including Servicing (member and provider), G & A, Provider...

Job Summary: To perform various administrative and technical tasks that will assist the claims department in handling... claims. Job Duties Notice of Loss: Review email and attachments received in the Notice of Loss mailbox to determine...

operations, and data audits to support the maintenance and growth of a regional health care provider network that meets... member of the Network team, applies in-depth knowledge of health care provider contracts and provider data, network...

claims: Determine correct level of reimbursement based on established criteria, provider contract, participating provider... and conforming to quality, production standards and specifications in a timely manner. Document provider claims/billing forms...

Alacrity Solutions TPA Claims Processor Alacrity Solutions is a full end-to-end provider delivering streamlined... insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in...

provider of transportation services, with a highly integrated network of people, technology and physical assets. At XPO...What you'll need to succeed as an Analyst, Claims at XPO Minimum qualifications: Bachelor's degree or equivalent...

provider of transportation services, with a highly integrated network of people, technology and physical assets. At XPO...What you’ll need to succeed as an Analyst, Claims at XPO Minimum qualifications: Bachelor’s degree or equivalent...

a broad range of products to customers through a diversified, multichannel distribution network. Our Claims professionals... to know the business General Insurance is a leading provider of insurance products and services for commercial and personal...