- AAOS (Rosemont, IL)
- …Subject Matter Expert on HIPAA obligations for Registry operations and contracting ; collaboration with outside counsel on compliance with HIPAA/HITECH/CARES Act. ... Assists Compliance Specialist with processing trademark, copyright, and permissions requests. Prepares and reviews health care related agreements involving data… more
- Robert Half Office Team (Libertyville, IL)
- Description We are looking for an Insurance Verification Coordinator for our healthcare establishment located in Illinois. This position is 100% remote but does ... will be to handle oversight, management, coordination, and organization of payer contracting activities. You will be responsible for maintaining all company payer… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist , you will work with internal teams to provide cutting-edge solutions that will directly ... improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment...and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,… more
- CareFirst (Baltimore, MD)
- …Abilities (KSAs)** + Deep understanding of multiple reimbursement methodologies used in healthcare provider contracting . + Proven ability to build strong ... Ancillary, Vendor, Dental and Professional contracts as well as the contracting of more complex high-performance provider networks. Performs duties to coordinate… more
- Northern Light Health (Brewer, ME)
- …and developing corrective actions. .Working knowledge of functional areas of the healthcare and contracting departments impact on such .Excellent communications ... Northern Light Health Department: Managed Care Contracting Position is located: Cianchette Professional Blding Work...serve as an internal consultant with strong financial and healthcare business acumen as well as the ability to… more
- Molina Healthcare (Los Angeles, CA)
- …ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's ... California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with… more
- Molina Healthcare (NY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... to business and system requirements of customers as it pertains to contracting , network management and credentialing. **JOB DUTIES** : Negotiates assigned contracts… more
- Veterans Affairs, Veterans Health Administration (White River Junction, VT)
- Summary Employee will serve as a Supervisory Mobility Transportation Specialist located at the Veterans Healthcare System in White River Junction, VT. ... including patient transport, Special Mode Travel (SMT), mileage reimbursement claims , transportation contracts, 911 ambulance claims , inter-facility transfers,… more
- CareOregon (Portland, OR)
- …Work closely with other internal departments, including, but not limited to Claims , Utilization Management, Credentialing, Provider Data, and Contracting to ... Job Title Provider Relations Specialist Lead Department 116-Provider Relations Exemption Status Exempt...to enhance the provider experience, quality of care and healthcare transformation. + Act as a key liaison to… more
- CareOregon (Medford, OR)
- …contractor and must comply with all federal laws. Job Title Provider Relations Specialist I Department 116 - Provider Relations Exemption Status Exempt Requisition # ... Work may be focused on physical, behavioral, and/or community-based healthcare services. Essential Responsibilities Provider Development & Education + Develop… more
- CareOregon (Portland, OR)
- Job Title Provider Relations Specialist II Exemption Status Exempt Department Provider Relations Manager Title Provider Relations Supervisor Direct Reports n/a ... Work may be focused on physical, behavioral, and/or community-based healthcare networks. Essential Responsibilities Provider Development & Education + Develop… more
- Amergis (Chicago, IL)
- …in: provider data management, credentialing or healthcare operations (ie claims processing, billing, provider relations, or contracting ) experience within a ... / hour Amergis is seeking a Provider Data Operations Specialist facilitates all provider data upload files for the...Excel, specifically formula set up to upload rosters and claims as this is a primary function of the… more
- Guthrie (Sayre, PA)
- Position Summary: The Provider Enrollment Specialist reporting to the Payor Contracting & Provider Enrollment Manager plays an essential role in ensuring the ... provider demographics and credentials in the Council for Affordable Quality Healthcare (CAQH) national credentialing database. 4. Completes monthly and quarterly… more
- Centene Corporation (Tempe, AZ)
- … related field preferred. 5+ years of sales, provider relations, or contracting experience. Claims processing and/or managed care experience preferred. Driver's ... providers, the health plan and Corporate to investigate and resolve provider claims **This position is a field-based position requiring travel within the Tempe,… more
- Sutter Health (Los Altos, CA)
- …risk contracts under design. Ensures successful contract performance. Assists with the contracting process to develop and expand of our provider networks. Audits ... administration of Managed Care lives. Provides analytical support for budgeting and contracting in addition to offering support and ongoing education to the provider… more
- Elevance Health (Meridian, ID)
- **Title: Network Data Specialist Sr** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of ... our PulsePoint locations. The **Network Data Specialist Sr** will be responsible for accurate, timely maintenance of complex provider information and synchronization… more
- Magellan Health Services (Boise, ID)
- …Care/ Healthcare environment with experience in eligibility, authorization and claims problem resolution. 2+ years' experience in network development with ... extensive experience working directly with tribal governments. + Tribal healthcare experience preferred. + The Liaison will be the...demonstrated focus on contracting and rate negotiation. Excellent organizational and rate negotiation… more
- Sedgwick (Columbus, OH)
- …equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting , servicing and ... Most Loved Workplace(R) Forbes Best-in-State Employer Provider Network Negotiation Specialist **PRIMARY PURPOSE** **:** To negotiate fee-for-service ancillary contracts… more
- Centene Corporation (Tucson, AZ)
- …in related field or equivalent experience. 2+ years of combined managed healthcare and provider reimbursement experience. Claims processing and/or managed care ... Educate providers regarding policies and procedures related to referrals, claims submission, credentialing documentation, web site education, Electronic Health… more
- Centene Corporation (Tempe, AZ)
- …Educate providers regarding policies and procedures related to referrals, claims submission, credentialing documentation, web site education, Electronic Health ... incentive agreements + Conduct site visits when required + Perform other contracting duties as requested, including but not limited to recommending changes to… more
