Jobs in Nightcliff
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Primary duties
may include, but are not limited to :
- Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective.
-...
ttcportals.com -
Primary duties
may include, but are not limited to : Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal...
ttcportals.com -
SCHEDULE : Full-time
Your Talent. OurVision . At Anthem, Inc., it’s a powerful combination, and the foundationupon which we’re creating greater access to care for our members, greater valuefor our...
ttcportals.com -
Primary duties
mayinclude, but are not limited to :
- Manages theday-to-day configuration activities
- Analyzesbusiness requirements and objectives towards determining the optimalconfiguration of...
ttcportals.com -
Anthem - Nightcliff NT - Operations
Primary duties
may include, but are not limited to :
- Manages theoperational performance of key areas to assure each department is meetingcompliance and business thresholds.
- Ensuresdeficiencies...
ttcportals.com -
Anthem - Nightcliff NT - Manager
Primary duties
may includes, but are not limited :
- Managing incoming calls or incoming post services claims work.
- Determines contract and benefit eligibility
- Provides authorization for...
ttcportals.com -
Anthem - Nightcliff NT - Manager
Primary duties
may includes, but are not limited :
- Managing incoming calls or incoming post services claims work.
- Determines contract and benefit eligibility
- Provides authorization for...
ttcportals.com -
Primary duties
may include, but are not limited to :
- Ensures integration of quality into the overall business process.
- Performs assessments to identify gaps in the enterprises quality and...
ttcportals.com -
Primary duties
may include, but are not limited to :
- Audits finalizedclaims payments and looks for errors in payment by comparing to Providercontracts, Health Plan policies, CCI edits, CMS payment...
ttcportals.com -
Primary duties
may include, but are not limited to :
- Leads the design and implementation of all configuration and benefit set up in core system.
- Researches new programs, involving major...
ttcportals.com -
Anthem - Nightcliff NT - Analyst
Primary duties
may include, but are not limited to :
- Represents the highest level of expertise that is required to respond to regulators, media inquiries, member and provider issues escalated to...
ttcportals.com -
Anthem - Nightcliff NT
Primary duties
may include, but are not limitedto :
- Receives provider applications and contactsproviders for any additional supporting documentation or clarification.
- Builds file documentation...
ttcportals.com -
Anthem - Nightcliff NT - Auditor
Primary duties
may include, but are not limited to :
- Performs audits of and may adjudicate high dollar claims while maintaining acceptable levels of claims inventory and age.
- Ensures claim...
ttcportals.com -
Anthem - Nightcliff NT - Analyst
Primary duties
may include, but are not limited to :
- Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting or other research.
-...
ttcportals.com -
Primary duties
mayinclude, but are not limited to :
- Determines theimpact of new federal or state regulations on provider files.
- Develops andmaintains departmental policies and procedures....
ttcportals.com -
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Jobs near Nightcliff:
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