FULL_TIME

FEED

OTHER

In support of TRICARE beneficiaries enrolled in the Autism Care Demonstration (ACD), the Autism Services Navigator (ASN) collaborates and oversees the assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services for TRICARE beneficiaries diagnosed with autism spectrum disorder (ASD). • Current unrestricted licensure in an appropriate state or territory of the United States, as a Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Social Worker (LCSW), Registered Nurse, or other licensed mental health professionals who possess a Certification in Case Management (CCM).

TriWest Healthcare Alliance

Autism Services Navigator

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Technical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.

Supervisor, Utilization Management

UNKNOWN

Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Necessary Contacts: In order to effectively fulfill this position, this position must be in contact with: Various internal and external entities including, but not limited to, all levels of BCBSLA personnel, attorneys, group leaders, members, hospitals, physician offices, and DOI.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Supervisor, Provider Disputes

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Reporting to the manager of the team, we assist Network Administration staff, Network Operations staff, Information Technology staff, Benefits Administration staff, Provider Audit staff by developing and implementing project/program narratives and responding to concerns on new and existing reimbursement programs, billing guidelines, and system requirements to ensure accurate implementation and maintenance of provider reimbursement programs, under the direction of the departmental director and working closely with more senior level reimbursement staff. Level placement and promotional readiness will consider SQL proficiency, analytical judgment, independence, healthcare knowledge, breadth and depth of expertise, complexity of assignments, ability to work across business areas, project leadership, technical direction, and organizational influence.

Healthcare Reimbursement Analyst

Blue Cross and Blue Shield of Louisiana

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Partner with all levels of senior and divisional management and staff in Institutional Reimbursement, Professional Reimbursement, Medical Coding, Network Operations/Administration, Health Informatics, IT, BET, Clinical Solutions, Benefits Administration, Corporate Project Management, EIM, external vendors and consultants, and the Blue Cross Blue Shield Association to support effective implementation and continuous improvement of value-based initiatives. All Levels: Bachelor's degree in statistics, accounting, finance, math, business administration, healthcare administration, or a related field is required (four years of related experience may be used in lieu of a Bachelor's degree); an MBA, MHA, or CPA is preferred.

Senior Or Lead Value Based Operations Analyst

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Value Based Operations Analyst

Partner with all levels of senior and divisional management and staff in Institutional Reimbursement, Professional Reimbursement, Medical Coding, Network Operations/Administration, Health Informatics, IT, BET, Clinical Solutions, Benefits Administration, Corporate Project Management, EIM, external vendors and consultants, and the Blue Cross Blue Shield Association to support effective implementation and continuous improvement of value-based initiatives. Excellent organizational, mathematical, analytical, oral and written communication, and report preparation skills are required, including the ability to present complex information clearly to executive management and employees at all levels.

Senior or Lead Value Based Operations Analyst

Applies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.

Utilization Clinical Reviewer

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).

Program Integrity Investigator

Provides consultation on business requirements and functional specifications in logical program designs, code modules, application systems, and software solutions; facilitates the transition to high level design and supports the project lifecycle with input from leadership where needed. Serves as a technical lead for project teams throughout the implementation and maintenance of business and enterprise software solutions by leveraging partnerships with technology teams and business leaders to resolve escalated issues.

YEAR

Old Dominion Freight Line Inc

Application Delivery Technical Lead

Mental Requirements: Learn new tasks, remember processes, maintain focus, complete tasks independently, make timely decisions in the context of a workflow, ability to communicate with employees and visitors, ability to complete tasks in situations that have a speed or productivity. Prepares patients for examination by performing preliminary physical tests; drug & alcohol screening, audiograms, EKG's, pulmonary function test, respirator fit.

Prime Occupational Medicine

Fingerprint Technician/Medical Assistant

Talent Acquisition

As a Senior Salesforce Developer with over 8 years of experience, you will play a crucial role in designing, developing, and implementing configured / customized solutions within the Salesforce platform to meet the specific needs of our organization. LWCC has been consistently recognized by industry leaders and named to the Ward's 50 group of top-performing insurance companies, supporting our promise to provide safety, security, and stability to businesses in Louisiana.

Louisiana Workers' Compensation Corp

Senior Salesforce Developer

The Senior Software Developer will develop modular Python-based analytical applications and supporting software, contribute to differential privacy and disclosure-avoidance tools, build evaluation applications, support production analytical pipelines and automated output generation, develop dashboards and technical tools, ensure reproducibility and scalability, and support documentation, testing, training, and Government knowledge transfer. E-Logic, Inc. is seeking a Senior Software Developer to support the development, testing, implementation, validation, and optimization of software applications and analytical tools supporting the IRS RAAS Statistics of Income (SOI) Division's production of differentially private Qualified Opportunity Zone statistics.

E Logic

Senior Software Developer

The Hire Talent

We are seeking experienced Senior Software Engineers to design, build, and maintain software solutions for our clients across multiple locations. You will lead technical work from design through deployment, write clean and reliable code, and work closely with project teams and client stakeholders.

Compu-Vision Consulting Inc.

Senior Software Engineer - RJLA #2

TalentNest

Maintains the overall cleanliness of the office as needed to support the team and clinic environment, which may include, but not be limited to, taking out garbage, organization and cleanliness of desk, patient and office space and assistance with other team members to achieve a strong professional appearance for our employees, patients and visitors. Level 2: High School Diploma or its equivalent with a current CPR license* and 3 years’ experience in billing and coding and intermediate computer skills, which include typing 70-100 words per minute, knowledge of Microsoft Office including, word and excel.

Fast Pace Health

Patient Care Specialist (Medical Receptionist)

[AW]-iCims

Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers.

FMOL Health

Oncology Claims Analyst 1

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Maximus is a trusted federal partner supporting the Internal Revenue Service (IRS) in delivering essential services that help taxpayers navigate and meet their tax obligations.

MAXIMUS provides business services to help governments operate health and human services programs, mostly at the state and national levels. The company's health services segment offers outsourced program management and administrative services,

Maximus

Senior ALC Developer

This role works closely with Project Managers, Superintendents, Project Administrators, vendors, subcontractors, and Corporate Accounting to ensure project costs and revenues are accurate and aligned with the budget. Key Working Relationships Collaborates with Project Managers, Superintendents, Project Administrators, Estimating, Corporate Accounting/Finance, vendors, subcontractors, and customers.

Coding Manager Jobs in Baton Rouge, LA

Autism Services Navigator TriWest Healthcare Alliance

Supervisor, Utilization Management TriWest Healthcare Alliance

Supervisor, Provider Disputes Blue Cross and Blue Shield Association

Healthcare Reimbursement Analyst Blue Cross and Blue Shield Association

Supervisor, Provider Disputes Blue Cross and Blue Shield of Louisiana

Senior Or Lead Value Based Operations Analyst Blue Cross and Blue Shield Association

Value Based Operations Analyst Blue Cross and Blue Shield Association

Healthcare Reimbursement Analyst Blue Cross and Blue Shield of Louisiana

Senior or Lead Value Based Operations Analyst Blue Cross and Blue Shield of Louisiana

Utilization Clinical Reviewer TriWest Healthcare Alliance

Program Integrity Investigator TriWest Healthcare Alliance

Application Delivery Technical Lead Old Dominion Freight Line Inc

Fingerprint Technician/Medical Assistant Prime Occupational Medicine

Senior Salesforce Developer Louisiana Workers' Compensation Corp

Senior Software Developer E Logic

Senior Software Engineer - RJLA #2 Compu-Vision Consulting Inc.

Patient Care Specialist (Medical Receptionist) Fast Pace Health

Oncology Claims Analyst 1 FMOL Health

Senior ALC Developer Maximus

Project Accountant Dynamic Group

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