Jobs near Indianapolis: 6,504
RS
Relevance Score ranked on: CLAIMS ANALYST
Claims Analyst III- Overpayment Prevention
INDIANAPOLIS, 220 VIRGINIA AVE
Assessing overpayment opportunities by reviewing low to high-volume claim samples. Obtain, interpret, and apply provider and member contract language, company claims policies, and coding guidelines to support prevention opportunities. Partnering closely with query data analysts to ensure requirements...
Search Terms: Claims Analyst, Payment, Claims, Analyst, Project Management
88.4
0mi
Updated: August 21
Audit & Reimbursement Senior- Medicare Cost Report Audit
INDIANAPOLIS, 220 VIRGINIA AVE
Prepare and perform supervisory review of cost report desk reviews and audits. Review of complex exception requests and CMS change requests. Perform supervisory review of workload involving complex areas of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing and ...
Search Terms: Audit, Senior, Accounting, Healthcare, Benefits
0
0mi
Updated: September 20
Population Health Management Pharmacist – CarelonRx
INDIANAPOLIS, 220 VIRGINIA AVE
Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals. Serves as a clinical resource to other pharmacists and contracted providers in areas such as prospective, inpatient, and retrospective DU - Rs and clinical ...
Search Terms: Pharmacist, Health, Management, Pharmacy, Healthcare
0
0mi
Updated: September 20
Investigator II - Carelon Payment Integrity SIU
INDIANAPOLIS, 220 VIRGINIA AVE
Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claims systems for review of facility, professional, and pharmacy claims. Responsible for identifying and developing enterprise-wide specific healthcare investigations that may ...
Search Terms: Investigator, Payment, Integrity, Healthcare, Business Services
0
0mi
Updated: September 20
Commercial Formulary Pharmacist - CarelonRx
INDIANAPOLIS, 220 VIRGINIA AVE
Leads Commercial formulary management processes. Responsible for all member, stakeholder, and provider communications regarding formulary changes. Ensures appropriate formulary set-up and claims adjudication. Serves as a clinical pharmacy resource to pharmacy benefit management and pharmacy operation...
Search Terms: Pharmacist, Commercial, Pharmacy, Healthcare, Compensation
0
0mi
Updated: September 20
Health Insurance Exchange Pharmacist - CarelonRx
INDIANAPOLIS, 220 VIRGINIA AVE
Lead Health Insurance Exchange formulary management processes. Responsible for all member, stakeholder, and provider communications regarding formulary changes. Ensure appropriate formulary set-up and claims adjudication. Serve as a clinical pharmacy resource to pharmacy benefit management and pharma...
Search Terms: Health, Pharmacist, Insurance, Healthcare, Pharmacy
0
0mi
Updated: September 20
Investigator Senior
INDIANAPOLIS, 220 VIRGINIA AVE
Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. Responsible for independently identifying and developing enterprise-wide specific healthcare investigatio...
Search Terms: Investigator, Senior, Healthcare, Technology, Insurance
0
0mi
Updated: September 20
Plan to Plan Service Specialist II
INDIANAPOLIS, 220 VIRGINIA AVE
?Supports inquiries from other BCBS Plans that were unable to be resolved through normal channels. Works with internal business partners (sales, member experience, claims, medical review, appeals, etc.) and external contacts within the other Blues plans to address all inter-Plan claims issues. Perfor...
Search Terms: Specialist, Customer Service, Customer Experience, Service, Business Partner
0
0mi
Updated: September 20
Plan to Plan Service Specialist III
INDIANAPOLIS, 220 VIRGINIA AVE
?Supports inquiries from other BCBS Plans that were unable to be resolved through normal channels. Works with internal business partners (sales, member experience, claims, medical review, appeals, etc.) and external contacts within the other Blues plans to address all inter-Plan claims issues. Perfor...
Search Terms: Specialist, Customer Service, Customer Experience, Service, Business Partner
0
0mi
Updated: September 20
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