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Health Care Service Corporation
Health Care Service Corporation
H1B vizos rėmėjasDraudimasKonsultavimasSveikatos priežiūra
„Health Care Service Corporation“ (HCSC) yra nepriklausoma „Blue Cross Blue Shield Association“ licencijos turėtoja ir viena pagrindinių JAV sveikatos draudimo bei sveikatos priežiūros paslaugų organizacijų. Ji teikia paslaugas beveik 23 milijonams žmonių, siūlydama draudimo ir išmokų programas darbdaviams, fiziniams asmenims, šeimoms bei „Medicare“ ir „Medicaid“ nariams. Be sveikatos draudimo, HCSC teikia vaistinių paslaugas, gyvybės ir dantų draudimą bei sveikatos duomenų technologijas. Beveik šimtmetį sukaupta patirtis leidžia įmonei veikti draudimo, sveikatos priežiūros ir konsultavimo srityse, siekiant didinti prieinamumą prie priežiūros, gerinti sveikatos rezultatus ir padėti nariams bei bendruomenėms valdyti išlaidas. Plati įmonės veikla suteikia karjeros galimybių sveikatos išmokų, sveikatos priežiūros paslaugų, technologijų, duomenų ir susijusių verslo funkcijų srityse.
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Coding Investigator Auditor (Remote, U.S.)

Health Care Service Corporation seeks a remote Coding Investigator Auditor to validate clinical, billing, and coding claims across eligible U.S. locations. The role audits payments, researches discrepancies, documents findings, and coordinates investigations.

USJungtinės ValstijosILIlinojusMTMontanaNMNaujoji MeksikaOKOklahomaTXTeksasas
63 300 $ – 114 300 $ / metai
NuotolinisVisas etatasVidutinis lygisVyresnysis specialistasPrivaloma Kalba: anglųAuditorius

Aprašymas

  • Review clinical, billing, coding, and lowest-cost-setting services before and after payment
  • Apply medical, contractual, legislative, policy, and related information to validate submitted and billed claims
  • Research relevant issues and records
  • Document audit findings clearly and accurately
  • Consult with special investigations and affordability-of-care teams when needed
  • Coordinate with the medical director, special investigations, customer service, PASS, network management, marketing, case management, medical review, legal, pricing, and database departments

Reikalavimai

  • Bachelor’s degree required; one year of business, law enforcement, or regulatory agency experience may substitute for each year of college
  • Hold a certified coding credential or obtain one within 24 months of hire
  • Bring three years of experience with claims processing operations and reporting systems, including two years auditing or developing computer system reports
  • Understand accreditation standards such as URAC and NCQA, along with health insurance legislation
  • Understand claims processes and claims processing systems
  • Demonstrate PC proficiency with Microsoft Word, Excel, and health insurance databases
  • Communicate effectively in writing and verbally with physicians, members, and providers, and prepare and explain documented findings
  • Demonstrate strong organization and prioritization skills
  • Current AAPC Medical Coding Certification is preferred
  • Work remotely within the continental United States, excluding California, New York, Alaska, and Hawaii

Privalumai

  • Annual incentive bonus plan
  • Health and wellness benefits
  • 401(k) savings plan
  • Pension plan
  • Paid time off
  • Paid parental leave
  • Disability insurance
  • Supplemental life insurance
  • Employee assistance program
  • Paid holidays
  • Tuition reimbursement
  • Additional incentive programs
  • Professional development opportunities
  • Remote work arrangement

Susiję darbai

Oregon Department of Human Services

Business Intelligence Analyst, Oregon Department of Education

Oregon Department of Human Services
KonsultavimasMaistas ir gėrimaiSveikatos priežiūra
USJungtinės ValstijosOROregonas
5 458 $ – 8 352 $ / mėnuo
HibridinisVisas etatasJaunesnysis specialistasVidutinis lygisPrivaloma Kalba: anglųVerslo analitikos analitikas

Build business intelligence systems and visualization tools using data on Oregon school facilities. Support data-informed administration and decision-making at the Oregon Department of Education.

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Endure Capital

Senior Analytics Engineer

Endure Capital
1 – 10 Darbuotojai
KonsultavimasRinkodaraSveikatos priežiūra
PLLenkijaNuotolinisVisas etatasVyresnysis specialistasPrivaloma Kalba: anglųAnalitikos inžinierius
DebesijaSQL

Build dbt data models for Numan’s AI-powered digital health platform and advance analytics across commercial, marketing, clinical operations, and patient outcomes. Set technical standards and guide analytical projects in partnership with teams across the business.

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