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HealthEdge
HealthEdge
1 001 – 5 000 Xodimlar
H1B vizasi homiysiKonsaltingSog‘liqni saqlashTibbiy sug‘urta
HealthEdge HealthRules Solutions Suite orqali tibbiy sug‘urta tashkilotlari uchun texnologiyalar ishlab chiqadi. Kompaniyaning platformalar portfeli raqamli da’volarni boshqarish, tibbiy yordamni boshqarish ish jarayonlari va to‘lovlar aniqligini qamrab oladi. Bu yechimlar tibbiy sug‘urta rejalari uchun operatsion ma’lumotlarni birlashtirish, asosiy jarayonlarni avtomatlashtirish, to‘lovlar aniqligini oshirish va a’zolar uchun yaxshiroq xizmat tajribasini ta’minlashga yordam beradi. Sog‘liqni saqlash va tibbiy sug‘urtaga e’tibor qaratadigan HealthEdge sug‘urta tashkilotlariga samaraliroq ishlash va tibbiy yordamni yanada yaxshi muvofiqlashtirishda ko‘maklashish uchun dasturiy ta’minot hamda konsalting tajribasini birlashtiradi.
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Kompaniyadagi ish o‘rinlari

Remote Claims Examiner II — HealthEdge

Adjudicate healthcare claims for HealthEdge’s health insurance operations platform, reviewing coding, coverage criteria, and payment edits. The role also includes mentoring junior colleagues and contributing to quality and process projects.

USAmerika Qo‘shma ShtatlariMasofaviyTo‘liq stavkaJuniorDiplom talab qilinmaydiTalab Qilinadigan Til: inglizchaSug‘urta da’volari bo‘yicha mutaxassis

Tavsif

  • Apply established policies and procedures to adjudicate healthcare claims.
  • Assess claim system data to determine service appropriateness and whether benefit coverage criteria are met.
  • Review adjudication edits and decide whether to pay claims or individual line items.
  • Process assigned claims using client guidelines or directions from the team lead.
  • Meet productivity goals and financial and procedural accuracy standards.
  • Mentor junior team members.
  • Support projects such as process documentation, training, quality audits, client surge work, and other assigned activities.
  • Raise issues and concerns with management, and take steps to maintain processing accuracy and quality.
  • Contribute to projects involving provider data, authorizations, enrollment, and related activities.

Talablar

  • High school diploma required.
  • One to three years of healthcare claims processing experience.
  • Sound understanding of claim data and ability to analyze it.
  • Knowledge of physician and hospital practices, coding, billing, and medical terminology.
  • Knowledge of CPT, HCPCS, ICD-10, UB-04, CMS-1500, and authorizations.
  • ICD-10, CPT, and HCPCS coding experience is a plus.
  • Willingness to learn new skills.
  • Collaborative approach to teamwork.
  • Strong work ethic.
  • Ability to adapt quickly in a fast-paced environment.
  • Self-motivated and quick to learn.
  • Ability to work collaboratively as part of a team.
  • May be required to complete a criminal background check before employment.

Imtiyozlar

  • Full-time, permanent employment.
  • Remote work environment.
  • Travel may be required based on company needs.
  • Reasonable accommodations are available for individuals with disabilities.
  • Equal opportunity employer committed to workforce diversity.

O‘xshash ish o‘rinlari

Aurora Energy Research

Research Associate, Japan Power and Energy Markets

Aurora Energy Research
501 – 1 000 Xodimlar
H1B vizasi homiysiIshlab chiqarishKonsaltingLogistika
JPYaponiyaGibridTo‘liq stavkaJuniorO‘rta darajaTalab Qilinadigan Til: inglizchaTalab Qilinadigan Til: yaponTadqiqot tahlilchisi

Research Associate at Aurora Energy Research, studying Japan’s power and energy markets. Develop quantitative analysis and client recommendations on energy policy, renewables, and the energy transition.

Ochish
Aurora Energy Research

Senior Research Analyst, China Energy Market — Singapore

Aurora Energy Research
501 – 1 000 Xodimlar
H1B vizasi homiysiIshlab chiqarishKonsaltingLogistika
SGSingapurGibridTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaTalab Qilinadigan Til: xitoyTadqiqot tahlilchisi

Research analyst role focused on Chinese energy markets at Aurora Energy Research, an electricity market modelling consultancy. Develop quantitative insights, support product development and share recommendations with clients.

Ochish