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📑 ***This person must reside in Kansas***Healthcare Fraud Shield, a leader in healthcare fraud prevention and payment integrity solutions, is looking for a talented Coder or Clinical Coder/Fraud Investigator to join our team.RESPONSIBILITIESWork with SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts-including performing quality check on wor ...

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📑 The SQL Software Engineer position will work independently and with a team to develop, implement, and maintain the claim import process. You will collaborate closely with the implementation team to ensure requirements are understood and implemented accurately.RESPONSIBILITIESFull ownership of your assigned tasks.Develop new and maintain existing cl ...

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📑 The SQL Software Engineer position will work independently and with a team to develop, implement, and maintain the claim import process. You will collaborate closely with the implementation team to ensure requirements are understood and implemented accurately.RESPONSIBILITIESFull ownership of your a ...

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📑 Reason for openings -quickly build out fraud controls process Risk and Fraud Controls Analyst (Not an investigator) Look through large data sets to define and build out reports Determine where fraud is taking place Knowledge of Fraud metrics/identity Must haves Heavy SQL, Looker. Big Query is nice to have ...

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📑 BlueAdvantage Network Provider Consultant page is loaded BlueAdvantage Network Provider Consultant Apply locations Flowood, MS time type Full time posted on Posted 15 Days Ago job requisition id JR100030 Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professi ...

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📑 *** Must have Healthcare experience*** Must have experience in: payment integrity, fraud detection, claims analysis*** REMOTE working in EST hoursProduct Manager - Data Science (Healthcare and Payment Optimization) Overview: We are seeking a talented Product Manager with a Data Scientist centric mindset who has experience working within Healthcare ...

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📑 Job Description SummaryExecutes measures for the prevention, identification and investigation of fraud, waste, and abuse (FWA) perpetrated against the Federal Employee Program (FEP). Ensures that Blue Cross Blue Shield (BCBS) Plans and Pharmacy Benefit Managers (PBMs) meet reporting requirements as mandated by the Carrier Letter and FEP Special Inv ...

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📑 Job Description SummaryExecutes measures for the prevention, identification and investigation of fraud, waste, and abuse (FWA) perpetrated against the Federal Employee Program (FEP). Ensures that Blue Cross Blue Shield (BCBS) Plans and Pharmacy Benefit Managers (PBMs) meet reporting requirements as mandated by the Carrier Letter and FEP Special Inv ...

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📑 Job Description:Role Summary/Purpose: This role is for a Product Owner of the Deposit Fraud Transformation SHIELD program, reporting to the VP, Consumer Bank Credit Leader. The ideal candidate will have a strong Deposit Fraud prevention and agile project background with a proven ...

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📑 Job DescriptionYour RoleThe Regulatory Law team supports Blue Shield’s Healthcare Solutions business team . The Associate General Counsel is a Senior Director position within the Regulatory Law Department and will report to the Managing Associate General Counsel. In this role you will primarily be supporting the Pharmacy business of Blue Shield of ...

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📑 Manager, Workforce Management – New Jersey/New York – Horizon Blue Cross Blue Shield of New JerseyPosted On: 3-21-2022Position Title: Manager, Workforce ManagementJob Location: New Jersey / New York areaCompany Name: Horizon Blue Cross Blue Shield of New JerseyContact Information: Adam H. Servetah, CPA (He/Him/His)Director Shared Services & Vendor ...

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📑 Shield Engineering provides outstanding opportunities for career growth and advancement. Our team members are given the opportunity to develop new technical skill sets, manage complex projects, and provide direction to our clients. We offer a stable work environment, as evidenced by the average years of experience with Shield. In order to attract t ...

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📑 Prospect House, 5 Thistle Street, Edinburgh EH2 1DF, GBWe believe in the power of ingenuity to build a positive human future.As strategies, technologies and innovation collide, we create opportunity from complexity.Our diverse teams of experts combine innovative thinking and breakthrough use of technologies to progress further, faster. Our clients ...

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📑 Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. BCBSAZ offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make be ...

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📑 Java Developer, Healthcare Analytics Hartford, CT, USA ● Virtual Req #26384 Tuesday, April 23, 2024 Company Overview and Culture EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together ...

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📑 Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!Modivcare is looking for an experience Corporate Counsel to join our team! This position will support the driving of healthcare and non-healthcare related legal and regulatory supp ...

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📑 SHAZAM is looking for call center professionals who can help identify and reduce fraud to protect cardholder accounts and minimize financial risks to our financial institutions. Must be able to work in a fast paced inbound and outbound call center environment that includes a variety of duties. If you have experience in banking, financial services, ...

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📑 About AscendionAscendion is a full-service digital engineering solutions company. We make and manage software platforms and products that power growth and deliver captivating experiences to consumers and employees. Our engineering, cloud, data, experience design, and talent solution capabilities accelerate transformation and impact for enterprise c ...

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📑 Join us as a Virtual Travel Booking Assistant, where your main task revolves around ensuring travelers have a seamless and memorable journey. Embrace remote work and utilize digital tools to assist clients with their travel arrangements. Responsibilities: Client Engagement: Interact with clients via email, phone, or chat to grasp their travel requi ...

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📑 As Head of Fraud, you will be accountable for the loss performance and fraud risk profile of Ally Bank.Your remit will include Fraud Strategy, Fraud Analytics and Fraud Operations.You will apply your strategic and analytical skills to lead a team that develops, evaluates, manages, and executes our fraud strategies to minimize fraud losses and ensur ...

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📑 Job Description SummaryExecutes measures for the prevention, identification and investigation of fraud, waste, and abuse (FWA) perpetrated against the Federal Employee Program (FEP). Ensures that Blue Cross Blue Shield (BCBS) Plans and Pharmacy Benefit Managers (PBMs) meet reporting requirements as mandated by the Carrie ...

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📑 About the CompanyThrough a digital-first, mobile-centric, highly configurable credit card solution, Deserve is powering the future of fintech. Using machine learning and alternative data, Deserve partners with universities, associations, financial institutions, fintechs, and modern consumer brands to develop, rapidly deploy and power white label an ...

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📑 Your RoleThe Global Business Services (GBS) department is responsible for delivering strategic and category supplier sourcing, contracting and governance excellence at Blue Shield of California. The Principal Sourcing Specialist (Supplier Procurement/Contracting) is responsible for the management and execution of the enterprise sourcing process ...

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📑 Anthem Blue Cross and Blue Shield is a proud member of the Elevance Health family of companies offering Medicare plans, Medicaid, individual and family plans, and group insurance plans in Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, Virginia and Wisconsin. Our group plans include a variety of group me ...

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📑 Work on the New Wave of Last Mile, Automated Warehouse Facilities:Your new company This fast growing MEP Engineering Consultancy works on projects including Solar, Campus, Multi-Family, High-Rise, Medical, Healthcare, Data Centers and more. Your new role With E-Commerce fast catching up on shop retail, there has been a rise in the need for last mil ...

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📑 Overview: A Virtual Travel Assistant is a remote professional responsible for managing all aspects of business-related travel for executives and employees within an organization. This role ensures seamless and efficient travel arrangements, optimizing time and resources, and providing a stress-free travel experience for clients. The Virtual Travel ...

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📑 We have partnered with a prominent Healthcare organization in New Jersey in search of a healthcare counsel to join a growing legal team. This role will report directly to the Vice President of Legal Services and be primarily responsible for healthcare contracting. With a collaborative team environment, great mentorship opportunities and a growing l ...

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📑 A growing community bank is looking for a Sr. BSA Analyst to play a vital role in safeguarding our institution against financial crimes such as money laundering, fraud, and other illicit activities. You will be responsible for ensuring compliance with relevant regulatory requirements while also proactively identifying and mitigating potential risks ...

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📑 Location: Holy Family HospitalPosted Date: 4/19/2024Job Type: Per DiemSalary: To be determined by experienceDepartment: 0301.52900 HFH Rad - DiagnosticJoin us at Holy Family HospitalNot many healthcare professionals have the opportunity to build a career with a great job and robust benefits while also caring for friends, family and neighbors. You c ...

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📑 Job Family:Client Relations Executive (CRE)Travel Required:Up to 50%Clearance Required:NoneWhat You Will Do:Increase Guidehouse solution penetration in designated market through account / clien ...

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📑 Account Manager - Renewal Specialist Remote U.S. (designated states) This position is fully remote and may be performed from one of the following U.S. states: AL, AZ, FL, GA, IN, KS, MA, MI, MS, NC, NV, OR, PA, SC, TN, TX, UT, VA. Department: Sales Reports To: VP of Sales (Upsell) The Account Manager - Renewal Specialist i s responsible for renewin ...

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📑 Varo is an entirely new kind of bank. All digital, mission-driven, FDIC insured and designed for the way our customers live their lives. A bank for all of us.Varo’s Financial Crimes Risk Management Team is composed of forward-thinking, creative, and enthusiastic individuals, who are constantly striving to safeguard the financial sector, our custome ...

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📑 Position Summary A Senior Mainframe Network System Programmer plans, installs, tests, administers, maintains, updates and implements VTAM, TCPIP, FTP, SFTP, TLS, CA/Spool, LRS VPS/DRS, InfoPrint, JQP, XPTR, Connect:Direct, XCOM, Enterprise Extender, Session Manager and mainframe network related software. Diagnoses, resolves, and documen ...

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