- Baylor Scott & White Health (Harrisburg, PA)
- …environment in a work environment. + Knowledge of healthcare and health insurance claims processing domains. + Ability to write complex SQL queries against ... relational databases. + Must possess excellent documentation and communication skills. + The ability to understand, model, and interpret data. + Accuracy and attention to detail. + Must possess good social skills. + Excellent written and verbal communication… more
- HUB International (Blue Bell, PA)
- …experience in managing policies, endorsements, renewals, data management, and assisting in claims processing . + **Market Research** : Support analysis of United ... States insurance markets and regional trends. + **Technical Training** : Participate in workshops and training sessions to strengthen your skills and industry knowledge. + **Reporting:** Prepare reports and presentations to communicate project updates,… more
- Highmark Health (Pittsburgh, PA)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed… more
- United States Steel (Pittsburgh, PA)
- …officers, construction, and other specialty lines, including coordinating invoice setup and processing , and allocating program costs to plants and business units. + ... experience with large deductibles, self-insured retentions, and construction programs. RMIS/ claims systems. What we offer + Competitive salary and benefits… more
- UPMC (Erie, PA)
- …coverage. + Work in collaboration with billing department to resolve open insurance claims as presented by walk-in patients. + Assists with other office functions as ... payer rules and regulations; and credit and collections laws + Word processing and computer experience required preferably including EPIC experience. + Experience… more
- Penn Medicine (Lancaster, PA)
- …shelves and verify all associated paperwork. + Assists in the creation, handling, processing and maintenance of a variety of pharmacy records, to promote efficient ... + Communicates with insurance carriers to obtain payment for prescription claims . Facilitates employee payroll deduction and/or medical billing for payment capture… more
- UPMC (Pittsburgh, PA)
- …in data collection, program implementation and reporting of results.,PRIOR AUTHORIZATION PROCESSING : possess a high level of knowledge regarding insurance prior ... information to correct insurance processor, troubleshoot and resolve rejected claims , reliably coordinate multiple benefit payers, including Medicare obtaining all… more
- Highmark Health (Harrisburg, PA)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed… more
- Guardian Life (Harrisburg, PA)
- …logs. + Deliver solutions that enhance underwriting risk assessment, claims auto-adjudication, and customer servicing. Operational Excellence + Establish scalable ... deep learning models including Large Language Models (LLM) and Natural Language Processing (NLP) + Hands-on experience with GPU, distributed computing and applying… more
- CVS Health (Monroeville, PA)
- …and partnering with account managers as needed in order to ensure accurate claims processing + Manage the Pharmacy benefit SalesForce.com Specialty Pharmacy ... Reimbursement queue ensuring timely review, resolution, and response + Resolve escalated PBM Client questions and / or issues independently + Identify trends within SalesForce.com case requests and escalate to management as necessary **Required… more