79 jobs found in nevada

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. You'll join a high caliber team where you're assisting, educating, problem - solving and resolving tenuous situations to the best possible outcomes. Bring your people skills, emotional strength and attention to detail. In return we offer the latest tools and most intensive training program in the industry. Get ready to start doin g your life's best work.SM Positions in this function are responsible for all related aspects of claim system processes and claim business rules. Includes claims systems utilization, capacity analyses / planning and reporting. Includes claims - related business and systems analysis. Ensures data integrity, data security and process optimization. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement. This position is full - time. Employees are required to work our normal business hours...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing  your life's best work.SM Imagine this. Every day in claims centers around the world, UnitedHealth Group is processing and resolving payment information for millions of transactions. Would you think we have some great technology? Would you think we know how to manage volume? You would be right. No one's better. And no company has put together better teams of passionate, energetic and all out brilliant  Associate Claims Representatives . This is where you come in. We'll look to you to maintain our reputation for service, accuracy and a positive claims experience. We'll back you with great training, support and...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Are you an experienced operational leader with a passion for developing successful teams and using data to tell a story to internal and external business partners? If so, then this role is for you! The Call Center Operations Manager leads all aspects of daily operations within our customer service teams; including hiring, directing, coaching, mentoring and developing new and existing frontline leaders. You should be passionate about collaborating with Gallagher offices nationwide to achieve exceptional service results. Duties and responsibilities: Manage and oversee the daily operations of call...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 34,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Reporting to the Call Center Operations Manager, the Supervisor leads call center agents as they provide service to our clients via phone, chat and email. This may include coaching, mentoring and developing team members to ensure they are achieving optimal service levels. Essential Duties and Responsibilities: Supervises a team of 15 - 20 call center representatives. Ensures timely and courteous service to all Gallagher clients. Trains and develops hourly associates within their department. Provides customer service support to the largest and/or most complex clients. Implements the Service...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)   No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. We are looking for an experienced Senior Consultant as an addition to the Optum Payment Integrity Practice in Optum Payer Consulting. Responsibilities require solid understanding healthcare claims data, basic PPS concepts, UB04 and HCFA 1500...

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) This is an opportunity that’s all about where you’ve been. Your experience. Your potential. Your skills. Because on the team at UnitedHealth Group, your potential and your impact can be career changing. No company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We’ll look for your experience and expertise to help keep our service levels and accuracy extremely high. We’ll also look for your ideas on how to constantly evolve our claims processes. We’ll back you with the great training, support and opportunities you’d expect from a Fortune 6 leader. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.   Primary Responsibilities: Researching and developing potential claim overpayment hypotheses Utilizing data mining tools (i.e. SQL, Access, Excel) in order to analyze data to support of their hypothesis Researching policies, coding guidelines, and regulations that would support the hypothesis being developed Developing Business Requirement Documentation in a clear, concise, and comprehensive manner...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Senior Provider Relations Advocate will be the assigned single point of contact for provider/healthcare system accounts while representing both government and commercial products to build and improve physician and practice manager satisfaction with UHC. This externally focused position will maximize the providers' ability to interact with UHC through both pre-scheduled engagements with the healthcare professional’s organizational representative to discuss new and upcoming changes occurring within UHC that will impact their specific account, discussing the provider/healthcare system’s organizational service issues, while also engaging on an...

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)   The Senior Underwriting (Pricing) Consultant will develop and implement departmental procedures and maintain high quality standards to ensure Underwriting efficiencies. This individual will develop departmental control expenses within the budget and oversee the assignment of underwriting authority to their reports. They will establish controls to monitor ability to accept risks and determine pricing. The Senior Underwriting Consultant will establish audit and monitoring procedures to ensure adequate review of underwriting files. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges....

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) As an Analytic Development Consultant, you will be responsible for supporting the identification, development, and presentation of new medical cost savings opportunities on behalf of our clients. This position will support assessment of new opportunities based on data insights leveraging tools, policies, industry trends, and by soliciting input from a broad network of experts across Optum. This position requires a strong analytical skillset, data analysis and healthcare claims experience (HCFA/UB) to detect incorrectly paid claims for...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) Be part of this enterprise-wide claims transformation journey! The Strategic Claims Capability vision is to reimagine and simplify the end-to-end claim experience by providing a nimble and frictionless claim capability for all constituents, driving maximum affordability. The work will be challenging and rewarding!  This is a transformational role and will require skills with positioning and managing change in a dynamic claim payment landscape. This role will be accountable for partnering with business leaders to define the strategy and roadmap for end-to-end provider and member payment experiences in support of enterprise objectives....

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) On the one hand, no industry is moving faster than health care. On the other, no organization is better positioned to lead health care forward than Optum and UnitedHealth Group. That’s what makes this opportunity so applause worthy. We have hundreds of business verticals across our matrixed organizations that are bringing thousands of new ideas, services and products to the marketplace every year. Our goal is...

If you are located in Las Vegas, NV, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges. Training is conducted virtually from your home. This role is an onsite role and once training is completed, you will transition to work in the office in the future. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life’s best work.SM Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self-Directed; These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful,...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Accountable for ownership of provider claim projects in an end-to-end process, from initial project contact, identification and resolution of claim payment issue, and communication of outcome to project contact Ability to educate provider on details of UHG reimbursement policies, etc., and related claim issues for the Medicare and Retirement COSMOS products Must possess a strong working knowledge of the Medicare and Retirement COSMOS products with the ability to interpret...

Combine two of the fastest-growing fields on the planet with culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making health care data available wherever and whenever people need it, safely and reliable. There’s no room for error. Join us and start doing  your life’s best work. (sm) This position is responsible for reviewing, investigating and completing the resolution of Provider Disputes in writing as set forth in laws pertaining to AB1455 for Commercial Health Maintenance Organization (HMO) Enrollees of Provider Disputes and Medicare Appeals for Medicare HMO Enrollees. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Reviews written dispute requests received from providers of denied or incorrect payments based on...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) This position will lead a team accountable for facilitating both governance efforts and operational issue resolution for value-based reimbursement (VBR) provider contractual arrangements.  This role also serves as a strategic and thought leader supporting the development of VBR related technology capabilities and business processes designed to improve the overall constituent experience and to enable the ongoing growth and market expansion of value-based contractual arrangements. This position acts as a key relationship builder with health plan, business segment and value-based provider senior leaders with a specific focus on each line of...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life’s best work.SM The  Senior Recovery / Resolution Analyst  will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules. This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm in residing time zone. It may be necessary, given the business...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing  your life's best work.(sm) As the PMO Hybrid Provider Advocate, you will be responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. As the Provider Relations Advocate you will design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Your responsibilities will also include directing and implementing strategies...

Gainwell Technologies LLC Summary As a  Business Analyst Claims  at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas. Help coordinate a business analyst team’s duties and activities on IT projects and nurture newer team members by providing guidance and support Be a knowledgeable bridge between clients, project managers and technical staff to define, document and share business requirements and expected impact  Work with the client to develop business specs at the start of a technical project Analyze, plan, design, document or...