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FEED

The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members.

YEAR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc

Medical Director - Clinical Advocacy and Support - Remote West Coast preferred

Medical Director - Clinical Advocacy and Support - Remote - PST preferred

Collaborate with internal departments, such as case managers, investigators, and administrative staff, to gather necessary information and support case management efforts. We are looking for an individual who is outgoing, focused, able to manage a high volume and time sensitive workflow effectively and efficiently.

Richard Harris Law Firm

Personal Injury Attorney - Las Vegas, Nevada

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In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.

HOUR

StratAcuity Staffing Partners Inc

Revenue Analyst

Our benefits extend beyond medical, dental, and vision coverage, including company-paid life and disability insurance, paid parental leave, tuition reimbursement, and family planning resources such as adoption and surrogacy assistance, for all full-time Team Members and all part-time Team Members. The updated operating model narrows Inventory ownership away from front sidewalk/sidelot presentation and backroom/dock/assembly recovery, which are owned by Operations leadership.

TSC’s team members are passionate individuals dedicated to the rural lifestyle offering expertise and thousands of affordable, high-quality products to our customers. If you join us, you'll learn everything there is to know about our products and the way we do business. You'll have the chance to apply that knowledge and achieve your dreams—living life on your own terms.
We were founded in 1938 by Charles E. Schmidt as a mail order tractor parts business, and today we've grown into the largest operator of retail farm stores in America. We couldn't be prouder to be deeply connected to the people we serve and the land they love. As a publicly traded company with over 1,500 stores, we're growing by leaps and bounds. You'll find us in 49 states, and for those of you in the northwest and Hawaii we also own and operate Del's Feed & Farm Supply.

Tractor Supply

TM Receiver

FULL_TIME

OTHER

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

TriWest Healthcare Alliance

Program Integrity Investigator

equestftpin

Responsibilities Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO) The Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Job Description: Patient Account Specialist: Government Billing IN-OFFICE POSITION Customer Service Rep II is responsible for the maintenance and processing of patient accounts, the follow up and resolution of Commercial, Managed Care and third-party insurance accounts receivable balances.

University Health Services Inc

CUSTOMER SVC REP II - Government Department

This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. The Customer Service Rep I will be the first point of contact for new and existing customers insurance questions and will deliver a quality customer service experience that builds rapport and long-term relationships to encourage renewal/repeat business.

Markel Group Inc

Customer Service Representative

Markel Corporation

Customer Service Representative, Insurance

Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates.

Shields Health Solutions

Pharmacy Technician Refill Calls

GreenHouseAPI

Individuals with a degree in a healthcare-related field who possess professional clinical backgrounds with Medicare QIO experience with claim reviews or in performing medical reviews in support of MAC or RAC appeals, pre- and post-pay claims reviews, and utilization reviews preferred. Essential Education: Graduation from an accredited school of nursing and current licensure as Registered Nurse (RN) or accredited as a Health Information Management professional (RHIA, RHIT, CCS) with requisite coding experience, skills, and knowledge.

DOMA Technologies

Nurse Educator/Review Coordinator

Technical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.

Program Integrity Clinical Spc

You may qualify if you meet one of the following: GS-7: You must have completed or will complete a 4-year course of study leading to a bachelors from an accredited institution AND must have documented Superior Academic Achievement (SAA) at the undergraduate level in the following: a) Grade Point Average 2.95 or higher out of a possible 4.0 as recorded on your official transcript or as computed based on 4 years of education or as computed based on courses completed during the final 2 years of curriculum; OR 3.45 or higher out of a possible 4.0 based on the average of the required courses completed in your major field or the required courses in your major field completed during the final 2 years of your curriculum. GS-9: You must have completed 2 years of progressively higher-level graduate education leading to a masters degree or equivalent graduate degree: a) Grade Point Average - 2.95 or higher out of a possible 4.0 as recorded on your official transcript or as computed based on 4 years of education or as computed based on courses completed during the final 2 years of curriculum; OR 3.45 or higher out of a possible 4.0 based on the average of the required courses completed in your major field or the required courses in your major field completed during the final 2 years of your curriculum.

United States Air Force

Chemist

Psychologist

The coder collaborates closely with providers, the billing team, and the auditing function to clarify documentation, resolve discrepancies, and support coding audits and reviews. This role ensures accurate billing, proper insurance reimbursement, compliance with federal, state, and payer regulations (including LCD/NCD guidelines), and efficiency across revenue cycle operations.

Claims Specialist Jobs in Las Vegas, NV

Medical Director - Clinical Advocacy and Support - Remote West Coast preferred UnitedHealth Group Inc

Medical Director - Clinical Advocacy and Support - Remote - PST preferred UnitedHealth Group Inc

Personal Injury Attorney - Las Vegas, Nevada Richard Harris Law Firm

Revenue Analyst StratAcuity Staffing Partners Inc

TM Receiver Tractor Supply

Program Integrity Investigator TriWest Healthcare Alliance

CUSTOMER SVC REP II - Government Department University Health Services Inc

Customer Service Representative Markel Group Inc

Customer Service Representative, Insurance Markel Corporation

Pharmacy Technician Refill Calls Shields Health Solutions

Nurse Educator/Review Coordinator DOMA Technologies

Program Integrity Clinical Spc TriWest Healthcare Alliance

Chemist United States Air Force

Psychologist United States Air Force

CERTIFIED MEDICAL CODER (CMC) New Horizon Medical Solutions

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