At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's largest industries creating

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians. The Registered Nurse Case Manager will report to the FEP Department Ma

REQUIRED EXPERIENCE Take on a significant role within a world class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level. You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying d

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians. The Registered Nurse Case Managemen

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Claims Insurance Manager Medical Profe

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist providers and members with basic inquiries about claims, authorizations, benefits, and other issues Fostering and maintaining proactive, positive relations throughout the provider network by communicating with provider offices through face to face visits, emails, telephone

Must have High school diploma, GED or equivalent required, Two year degree preferred. Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization. Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system .

Take on an important role within an award winning health organization. Help ensure the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. You will receive urgent, routine, pre service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness.

Authorization Coordinator ENT Clinic Full Time 8 Hour Days (Non Exempt) (Non Union) Keck Medicine of USC Hospital Los Angeles, California The Authorization Coordinator coordinates communication with admitting, case management, patient financial services, and payers to ensure all inpatient services provided by the hospital are authorized by appropriate payer. He/She will f

Apply if looking for Flexibility and Financial Freedom

Coding Compliance Auditor (HIM Inpatient) HIM Financial Full Time 8 Hour Days (Non Exempt) (Non Union) Keck Medicine of USC Hospital Alhambra, California In accordance with current federal & state coding compliance regulations and guidelines, the 'IP Coding Compliance Auditor" performs 2nd level reviews of previously coded inpatient accounts for MS DRG validation purposes

Apply if looking for Flexibility and Financial Freedom