- Humana (Harrisburg, PA)
- …The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national ... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion… more
- Deloitte (Philadelphia, PA)
- …+ Support Epic enterprise implementation for a large academic medical center and health system in the Southeast region. + Conduct Epic Hospital Billing application ... Are you an experienced, passionate pioneer in technology? An industry solutions professional who wants to work in a collaborative environment. As an experienced Epic Resolute Hospital Billing Analyst Project Delivery Specialist, you will have the ability to… more
- Travelers Insurance Company (Wyomissing, PA)
- …negotiating and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...**What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures file… more
- Commonwealth of Pennsylvania (PA)
- …of crime, their families, and other claimants. You will conduct claim investigations, determine dispositions, and prepare reimbursements for victims or claimants. ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....- REVIEW FOR ACCURACY AND COMPLETENESS Review victim compensation claims for accuracy and completeness by obtaining and reviewing… more
- WellSpan Health (Chambersburg, PA)
- …tasks. Assists in the completion of submitting electronic and/or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches ... companies via electronic or manual processes and facilitates special billing for split claims , ancillary charges, interim bills, etc.- Resolves Claim edits to… more
- WellSpan Health (York, PA)
- …tasks. Assists in the completion of submitting electronic and/or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches ... companies via electronic or manual processes and facilitates special billing for split claims , ancillary charges, interim bills, etc.- Resolves Claim edits to… more
- PPL Corporation (Allentown, PA)
- …insurance program renewals for property and casualty lines, captive insurance management, claims , contract reviews for a wide variety of risks, management of the ... programs in place for specific business lines. + Support claims management activities such as monitoring status of ...exposure and incurred costs, and processing invoices related to claim payments. + Manage insurance certificates for both PPL… more
- UPMC (Pittsburgh, PA)
- …coding guidelines to claim processes + Ability to perform audits of claims processes and apply root-cause + Significant experience with Excel for data analysis ... Analyst to play a critical role in shaping how claims are processed and paid. This is your opportunity...you'll be the go-to expert for payment accuracy and claim editing. You'll work closely with our external software… more
- St. Luke's University Health Network (Allentown, PA)
- …and coordination of the activities related to third party claim form formats, claim "scrubbing," claim submission and claims editing to ensure optimal ... ESSENTIAL FUNCTIONS: + Provides guidance and/or assists AR specialists in third party claims submission process. + Assists in the prioritization of work for the… more
- Sedgwick (Harrisburg, PA)
- …of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for ... Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client… more
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