- UPMC (Pittsburgh, PA)
- …terminology and coding. + In-depth knowledge of electronic data interchange and claims processing , third party payer rules, reimbursement practices and ... with PBS billing staff to identify, analyze and resolve CDM-related claim submission issues. + Establish and maintain collaborative, customer-focused relationships… more
- Intermountain Health (Harrisburg, PA)
- …data to the clinical record. Leverages other system functionalities to expediate the claim processing for compliant and optimized hospital accounts. + Evaluates, ... Integrity Analyst II is responsible for appropriate charge capture, assigned account, claim edits and/or charge edits for an assigned service line. This position… more
- Commonwealth of Pennsylvania (PA)
- …position. Failure to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved score or ... addresses the items listed below which relate to your claim . If you indicated you have no work experience...addresses the items listed below which relate to your claim . If you indicated you have no work experience… more
- Commonwealth of Pennsylvania (PA)
- …position. Failure to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved score or ... addresses the items listed below which relate to your claim . If you indicated you have no work experience...addresses the items listed below which relate to your claim . If you indicated you have no work experience… more
- Datavant (Harrisburg, PA)
- …resolving complex coding edits efficiently and accurately to ensure timely and compliant claim processing .** **What You Will Do:** + Review medical records and ... and optimizing service outcomes in both hospitals and alternative care settings. ** Claim edit experience is required; Must be proficient in resolving claim… more
- AON (Fort Washington, PA)
- …day will look like: + This position is accountable for oversight and processing of beneficiary changes, assignment of benefits, and life insurance and disability ... claims submissions for the Insurance Trust. + A key...written correspondence + Identify customer issues requiring new business processing , increase in coverage and/or transfer issues that require… more
- Otsuka America Pharmaceutical Inc. (Harrisburg, PA)
- …**Data Integration & Management** + Explore and analyze common pharmaceuticals data (eg, claims ) as well as novel data sets based on lab and EHR systems. ... unified view of stakeholder interactions. + Apply natural language processing (NLP) to extract insights from unstructured medical texts,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Highmark Health (Pittsburgh, PA)
- …issues related to supported technology. Manage utilization review, translation of foreign claims , coordination of benefits (COB), and processing of claims ... employees. **GENERAL OVERVIEW** This job oversees, develops, and manages the end-to-end claims functions and operational inputs including but not limited to the… more
- Walmart (Reading, PA)
- …by ensuring proper policies and procedures are followed Ensures the timely processing of claims forexample damaged defective returned liquidated items and ... Manages facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of policiesprocedures… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …benefits, and SOP execution. Health Care Experience is required, specifically claim processing , contact center, benefit verification, or similar industry ... experience. Call Center and/or Claim Processing experience is a plus. + Problem-solving, results-oriented, active listening, and high attention to detail.… more
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