...evaluate HEDIS and Risk Adjustment Factor. Conduct internal reviews of documentation and billing on a timely basis. Identify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by utilizing official coding resources, Medicare manual and...
...training and support for Jira Cloud users Manage change requests and process improvements What Youll Need ~4+ years of Jira Software Cloud experience ~ Gaming industry experience REQUIRED ~ Hands-on with add-ons like Structure, eazyBI, ScriptRunner ~ Strong...
...Description: Are you an experienced apparel buyer or merchandiser with strong relationships in retail? PFD Style, a premium private-label garment manufacturer, is seeking apparel buyers and sourcing professionals interested in a flexible, commission-based role. Bring...
...requests, related to health services and performance research. Build internal and/or external research teams and serve as principal investigator on projects. Oversee staff when data analysis requires complex analytic design and/or including risk adjustment models....
...volume contact center environment or a similar environment preferred Knowledge of pharmacy benefits, health care insurance, and/or medical billing (preferred) Responsibilities - Responds to inbound phone calls and claims (as well as outbound calls) to/from...