Healthcare Resolution Specialist

Company OverviewUnitedHealth Group is a global organization that delivers care and pharmacy benefits to millions of people worldwide. We believe in creating a healthier atmosphere where everyone can thrive.About the RoleThe Healthcare Appeals Resolution Specialist will play a vital role in reviewing, researching, and resolving all types of appeals and...

The Clinical Resolution Specialist role at UnitedHealth Group is a vital component of our Prospective Investigations process. The primary responsibility of this position is to review medical records and determine the eligibility of claims for payment. This requires a high level of attention to detail and strong analytical skills to ensure compliance with...

Job Title: Prior Authorization Specialist IThe Prior Authorization Specialist I is a crucial role at APR Consulting, Inc., where you will be responsible for obtaining and resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government, and other payors across various healthcare...

Unified Women's Healthcare is a leading national platform for women's healthcare, comprised of over 900 care centers and 2,500 affiliates in 19 states. Our affiliate, Midwest Center for Women's Healthcare, is seeking a Full-Time OB/GYN physician for their practice in Park Ridge, IL. This position offers a unique opportunity to join a well-established and...

Job Summary:Credit & Collections Specialist plays a crucial role in ensuring timely payment of health insurance premiums and claims. This position is responsible for collection activities related to past due health insurance premiums and/or past due health insurance claims.Key Responsibilities:Follow established guidelines to collect past due insurance...

Role OverviewAs a Healthcare Compliance Specialist at Protalents, you will be responsible for conducting onsite reviews of practitioner offices and medical records. Your expertise will be invaluable in identifying improvement opportunities and providing guidance to practitioners on implementing corrective actions.Key ResponsibilitiesConduct onsite reviews of...

About the roleAbarca Health is seeking a skilled professional to join our PBM Operations & Services team as a Coverage Determination Specialist.The ideal candidate will possess strong analytical skills and the ability to communicate effectively with pharmacists, beneficiaries, and doctors.Responsibilities will include reviewing and responding to coverage...

Optum Collections Representative Job DescriptionAt Optum, we're dedicated to delivering care and improving health outcomes for millions of people worldwide. As a Collections Representative, you'll play a vital role in ensuring the financial well-being of our patients by resolving claims and providing exceptional customer service.Key Responsibilities:Comply...

Job Title: Catheterization Laboratory SpecialistJob Type: Travel Allied Health ProfessionalPRN Healthcare Services is seeking a skilled Catheterization Laboratory Specialist to join their team. The ideal candidate will have experience in catheterization laboratory procedures and a strong understanding of cardiac catheterization techniques.Key...

Purpose: As a key member of the Hospital San Juan Capestrano team, this role is responsible for facilitating effective communication on nursing units, ensuring seamless interactions between staff, patients, and other stakeholders.Key Responsibilities:• Assemble and maintain accurate patient charts for admissions, transfers, and discharges in accordance...

Job SummaryAs a key member of the Walgreens pharmacy team, the Pharmacist Healthcare Specialist oversees daily operations, ensuring seamless workflow management, exceptional patient care, and continuous quality improvement. This role requires adherence to company policies, compliance with regulatory bodies, and a strong focus on customer satisfaction.Key...

Job Summary:The Medical Support Specialist will coordinate the activities of the nursing staff, patients, physicians, and other hospital departments. This role requires excellent communication and organizational skills to manage supplies and equipment, perform general receptionist and clerical duties, and facilitate the efficient functioning of the nursing...

About the Role:We are seeking a skilled Cardiovascular Diagnostic Specialist to join our team at Garden City Hospital. As a Cardiovascular Diagnostic Specialist, you will assist in the preparation and execution of various cardiovascular procedures.Responsibilities:Assist in the preparation of the procedure room and ensure all necessary equipment and supplies...

Product Quality Assurance Specialist Job DescriptionAt Abarca Health, we are igniting a revolution in healthcare by redefining pharmacy benefits. We are seeking a Product Quality Assurance Specialist to join our team. This role will ensure that business requirements are developed accurately and configured into our claims adjudication platform.Key...

In a few words...Abarca Health is revolutionizing pharmacy benefits. Our Operational Performance team is dedicated to centralizing data to drive improvements.As an Issue Management Analyst, you will collaborate with key functional areas to ensure the quality and integrity of the claims processing system.Contribute to the definition of tactical and strategic...

Job Summary: We are seeking a highly skilled Healthcare Talent Acquisition Specialist to join our team at West Suburban Medical Center. This role is responsible for the recruitment and retention of qualified candidates, collaborating with executive leadership to establish effective recruitment strategies and performance expectations.Key...

Company OverviewOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.Job DescriptionThe Clinical Investigation Healthcare Specialist will be responsible for reducing medical costs by identifying waste and error in provider billing practices. This role involves determining the accuracy of bills...

Alois Healthcare seeks a skilled Medical Imaging Specialist - CT Technologist to work in Newberg, Oregon. The ideal candidate will have experience operating CT scan equipment, positioning patients, and interpreting physician instructions. Key responsibilities include accurately administering contrast materials, operating the CT scanner, and capturing...

Job Summary:As a Radiologic Diagnostic Specialist at Ahmc Healthcare, you will play a crucial role in ensuring proper radiologic diagnosis of patients. Under the direction of the department manager or designee, you will perform interpretive, patient care, and technical functions to achieve accurate diagnoses. Your participation in technical duties directly...

Medical Director / Physician Position SummaryThe Site Medical Director serves as the responsible Physician and health authority required by national standards. They provide overall supervision for clinical services for the site to ensure appropriate delivery of on and off site necessary medical care but have no other managerial responsibilities.Key...