- Actalent (Cary, NC)
- …process pharmacy claims in MIS. + Recognize and understand pharmacy claim responses. + Manage inbound calls from patients, clients, physicians, and payors ... possible care by effectively managing insurance communications, processing pharmacy claims , and assisting with various projects. Responsibilities + Recognize and… more
- Actalent (Cary, NC)
- …manage communications with patients, triage prescriptions, and process pharmacy claims efficiently. Responsibilities + Recognize and effectively communicate about ... HUB providers when Biologics is unable to serve the patient. + Process pharmacy claims appropriately in Biologics MIS. + Recognize and understand pharmacy claim … more
- CDM Smith (Greensboro, NC)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more
- Ansible Government Solutions (Durham, NC)
- Overview Ansible Government Solutions, LLC (Ansible) is currently recruiting Medical Support Assistants (MSA) to support the Durham VA Medical Center located at ... reception support in the Release of Information (ROI) offices at various medical centers. + Scan insurance cards, protect secure information, and complete all… more
- Baylor Scott & White Health (Raleigh, NC)
- …2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more
- Sedgwick (Raleigh, NC)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- CVS Health (NC)
- …**Position Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves ... metrics **Required Qualifications** + 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of benchmarking… more
- Highmark Health (Raleigh, NC)
- …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- Elevance Health (Durham, NC)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Works on large scale… more
- UNC Health Care (Kinston, NC)
- …posting, patient accounts receivable management and follow up, charge entry, EDI/ claim submission/ claims rejections, and external collection activities. Provides ... DME Billing Manager oversees the day-to-day operations of Down East Medical Supply's revenue cycle process including referral intake, billing, collections,… more