FULL_TIME

FEED

OTHER

Ensures accuracy and completion of authorization data from customer information, medical records, referral/authorization forms, Military Treatment Facility electronic transmission and other documents into medical management system. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

TriWest Healthcare Alliance

Referral Specialist

equestftpin

Senior Referral Specialist

UNKNOWN

The Coding Audit Specialist position conducts quality assurance activities to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and Department of Health Services (DHS); identifies deficiencies and provides management with an analysis of outcomes and tools for improving accuracy in coding. Responsible for auditing medical record documentation to determine appropriate diagnostic coding for services provided, taking into account the AMA CPT coding guidelines, ICD‐9 & ICD‐10 Coding Guidelines, CMS Medicare, HHS, and DHS BadgerCare Plus risk adjustment policy and Hierarchical Condition Category Coding.

HOUR

Sanford Health

Coding Audit Specialist, Health Plan

The incumbent will also work closely with MTF staff to support TRICARE beneficiaries and provide non-clinical support for patient referrals and authorizations; outreach to network providers as necessary; and to facilitate the support of applicable TriWest departments for resolving network gaps, provider and contract concerns, customer service requests, and discharge coordination for patients from network and non-network facilities. • Performs on-site and virtual outreach activities for military installation community and beneficiary groups such as Family Readiness Groups, Retiree Associations, and Installation New-comers Orientation, and provides educational briefings on such matters as transferring TRICARE enrollment, PCM selection, and other interest areas for new people to the community.

Field Support Specialist - Hybrid - San Antonio, TX

Bachelor’s degree in a technical discipline such as Computer Science, Engineering or related technical discipline and 3 years related experience, or; Completion of certification program at a technical or vocational school and 8 years related experience. The Network Specialist ensures that the Department of Defense (DoD) Defense Health Agency (DHA) LAN/WAN provides all required services, by supporting the network infrastructure with on-site troubleshooting and problem resolution.

YEAR

Quantum Sky

Network Specialist

[AW]-iCims

ADAPTED_NOW

Actual base salary will be determined by a variety of factors, including but not limited to, the scope of the role, relevant experience, job-related knowledge, education and training, key skills, and geographic market considerations. Eligible employees also gain access to a wide range of benefits from comprehensive health coverage and health savings accounts to retirement plans, life and disability insurance, and time-off programs that support work-life balance.

Serco, Inc. is the North America division of Serco Group, plc, one of the world’s leading service companies. At Serco we serve every branch of the U.S. Military, federal, state and local governments, Canadian and provincial governments, as well as commercial customers. We are a leading provider of professional, technology, engineering, trades, and management services, and we support the public service areas of Defense, Citizen Services, and Transportation.
Headquartered in Herndon, Virginia, Serco has over 9,000 employees working at over 100 sites across the U.S. and Canada. Serco is a business where people and values matter. Our workplace culture is one that embraces diversity and fosters equity, respect, and belonging for every individual. Put simply, Serco is a place you can count on. We embody a holistic approach to wellbeing and offer our employees a suite of benefits that enable you to achieve your physical, emotional, financial, social, community and career goals.
Serco is a place where you can make a difference because every contribution matters. So while your place at Serco may vary depending on your role, we know you will find your place here. You are invited to come discover your place in our world.

Serco

Information Specialist

Maintain assigned job functions related to Agency Services transactions including but not limited to: agent contracting set-up, updates to agent information and contracts, annualization and EFT, manage reports, research complex scenarios/inquiries, tax reporting, agent adjustments and agent bonuses. • Develop and maintain a comprehensive knowledge base of Agency Services including but not limited to: agent set-up and New Business requirements, agent contracting requirements/regulations, product level commissions calculations, bonus structures and new business requirements/regulations.

Sammons Financial Group

Customer Service Specialist - Life

As a Full Time Junior level Benefits Specialist, you will answer incoming calls and emails from customers about administrative actions, including educating and advising callers on their military benefits and resources available to them and their families. Actual base salary will be determined by a variety of factors, including but not limited to, the scope of the role, relevant experience, job-related knowledge, education and training, key skills, and geographic market considerations.

Junior Benefits Specialist (Full Time 100% Remote)

Respect the Individual: Embraces differences in people, cultures, ideas, and experiences; creates a workplace where associates feel seen, supported and connected through a culture of belonging; creates opportunities for all associates to thrive and perform; helps to attract the best talent. 3201 S LOUISE AVE, SIOUX FALLS, SD 57106-0704, United States of America Walmart and its subsidiaries are committed to maintaining a drug-free workplace and has a no tolerance policy regarding the use of illegal drugs and alcohol on the job.

What started small, with a single discount store and the simple idea of selling more for less, has grown over the last 50 years into the largest retailer in the world. Each week, nearly 265 million customers and members visit our more than 11,200 stores under 55 banners in 27 countries and eCommerce websites in 10 countries. With fiscal year 2018 revenue of $500.3 billion, Walmart employs over 2.2 million associates worldwide. Walmart continues to be a leader in sustainability, corporate philanthropy and employment opportunity. It’s all part of our unwavering commitment to creating opportunities and bringing value to customers and communities around the world.

Walmart

(USA) Member Specialist PT

(USA) Member Specialist

Working closely with senior team members, the incumbent collaborates with appropriate departments (Quality, Regulatory, R&D, Manufacturing, North America Marketing teams) to address customer needs, support product adoption, and contribute to customer satisfaction and business growth. The base pay actually offered to the successful candidate will take into account, without limitation, the candidate's location, education, job-knowledge, skills, and experience in prior relevant roles.

Haemonetics Corp

Product Application Specialist

The ACD Specialist lends administrative support to beneficiaries, clinical staff, and providers in support of the Autism Care Demonstration (ACD) The ACD is a benefit program for eligible TRICARE beneficiaries who have an Autism Spectrum Disorder (ASD) diagnosis, and provides a set of services not available under basic TRICARE benefits. Independent Thinking / Self-Initiative: Critical thinker with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without considerable direction and to find necessary resources.

Autism Care Demonstration Specialist

This role leads initiatives including duty drawback, Build America, Buy America (BABA), post-entry duty recovery programs, HTS classification optimization, trade agreement utilization, and CTPAT. The position works cross-functionally with internal stakeholders, customs brokers, and government agencies to identify savings opportunities, ensure compliance, and deliver measurable financial results.

EnerSys

Strategic Trade Program Specialist

GS-07: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Identifies, audits, posts and collects from third party health plan carriers; ensures compliance with established regulations and justification of vouchers, invoices, claims and other requests for payment; verifies requests made against the record of what was authorized; enters information into an automated financial accounting system for processing a payment; resolves difficult reconciliations. MINIMUM QUALIFICATIONS: GS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks:Utilizes diverse accounting and patient business procedures governing a wide variety of patient accounts to analyze and determine the need for, and type of adjustments necessary to reconcile and balance accounts.

US Department of Health and Human Services

Voucher Examiner

Examples of Dentistry experience may include the removal of decay; Filling cavities; Straightening, extracting, and repairing teeth, treating gum diseases; Performing corrective surgery; Making measurements/models for dentures to replace missing teeth, administering anesthetics, writing prescriptions; Administer treatment greater than usual difficulty, deal with cases presenting patient behavior and communication problems; Supervise a dental program, which includes managing the budget and staff. Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Qualifying experience involves the evaluation, prevention, diagnosis, and treatment of diseases, injuries, and disorders of the oral cavity and maxillofacial area.

Supervisory Dentist

Research, evaluate, and implement quarterly and ongoing updates to medical coding, reimbursement methodologies, regulatory requirements, and health plan policies to ensure system configurations remain current and compliant with CMS, Medicare, Medicaid, ACA, HIPAA, NCQA, and commercial payer requirements. The position is responsible for validating claims processing and logic, maintaining coding integrity, troubleshooting configuration issues, and supporting continuous system optimization to improve automation, regulatory compliance, operational efficiency, accurate claims payment and provider coding reconsiderations.

Avera

Configuration and Coding Analyst

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Avera Health

Configuration And Coding Analyst

Certifications - Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA); Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC). Current Employees: If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Medical Reimbursement Specialist Jobs in South Dakota

Referral Specialist TriWest Healthcare Alliance

Senior Referral Specialist TriWest Healthcare Alliance

Coding Audit Specialist, Health Plan Sanford Health

Field Support Specialist - Hybrid - San Antonio, TX TriWest Healthcare Alliance

Network Specialist Quantum Sky

Information Specialist Serco

Customer Service Specialist - Life Sammons Financial Group

Junior Benefits Specialist (Full Time 100% Remote) Serco

(USA) Member Specialist PT Walmart

(USA) Member Specialist Walmart

Product Application Specialist Haemonetics Corp

Autism Care Demonstration Specialist TriWest Healthcare Alliance

Strategic Trade Program Specialist EnerSys

Voucher Examiner US Department of Health and Human Services

Supervisory Dentist US Department of Health and Human Services

Configuration and Coding Analyst Avera

Configuration And Coding Analyst Avera Health

Configuration and Coding Analyst Avera Health

Coder II Monument Health Rapid City Hospital

Coder II Monument Health.

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