Compliance & Coding Audit Specialist Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education
Scheduled Hours40 Position SummaryPerforms follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records, and claims, contacting insurance companies as well as other related duties to expedite payments from various payers
Scheduled Hours40 Position SummaryPosition performs various professional services to ensure medical, drug, and diagnostic testing authorizations are obtained in an efficient manner and that reimbursement is maximized through required interaction with third-party payers; leads the pre-certification team
By joining Sedgwick, youll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with
Job DetailsJob Location: Rockford, IL 61108Position Type: Full TimeSalary Range: $45.00 - $52.00 HourlyTravel Percentage: NoneAre you passionate about clinical quality, accuracy, and continuous improvement -and looking for a role that allows you to make a
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive
Who We Are: Since 1906, New Balance has empowered people through sport and craftsmanship to create positive change in communities around the world. We innovate fearlessly, guided by our core values and driven by the belief
Scheduled Hours40 Position SummaryAdvanced level specialization in complex pre-certifications as indicated on therapy and treatment plans to prevent controllable losses/write offs for the Department. May perform rechecks of insurance eligibility and verify authorization information for each
Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine
Cigna-Evernorth Services Inc. seeks a Software Engineering Advisor for the St. Louis, MO location to design, develop, and maintain complex enterprise software applications. Responsibilities: • Architect, write, and enhance sophisticated software solutions that support mission critical
LocationST. LOUIS, MO 63110 Scheduled Hours40 Position SummaryResponsible for clinical program management, including program planning, implementation and evaluation. Promotes the delivery of care, based on the program philosophy. Responsible for oversight of daily operations related to
LocationJefferson City, MO 65102-0720 Scheduled Hours40 Position SummaryPosition performs varied professional services to ensure medical/surgical and diagnostic/ancillary services are accomplished in an efficient manner and that reimbursement is maximized through required interaction with third-party payers Job Description
Program Management Senior Advisor, Payment Policy and Coding Business Implementation Lead (BIL) The Program Management Senior Advisor (Band 4, Individual Contributor) is a senior operational leader responsible for ensuring the accurate, compliant, and high-quality execution of regulatory
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system accurately