- UNC Health Care (Chapel Hill, NC)
- …outstanding insurance claims follow up for no response from payors, and/or claim denials. + Works physician claims ("professional billing"). + Maintains A/R ... at acceptable aging levels by prompt follow-up of unpaid claims and denied claims . + .Performs all duties in a manner which promotes teamwork and reflects UNC… more
- Highmark Health (Raleigh, NC)
- …requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and ... and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES** +… more
- Lincoln Financial (Raleigh, NC)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... a clinical resource for Group Protection benefit specialists and claim professionals. You will evaluate medical information...this role you will provide coaching and guidance to claims regarding medical management. **What you'll be… more
- UNUM (Raleigh, NC)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- VetsEZ (NC)
- …Intelligent Document Processing (IDP) pipelines to extract and validate data from claims , authorizations, and medical documentation. + Integrate LLMs and ... care teams, payers, and providers to improve how patients experience care, how claims are processed, and how care coordination is managed across the continuum. By… more
- Lowe's (Mooresville, NC)
- **Your Impact** The Sr Analyst-Workers Compensation Claims will provide insight and support to drive the operational excellence of the Workers Compensation Program. ... Will Do** + Evaluates monthly, quarterly, and annual performance of claims administrator and subcontracted vendors through analyses such as cost-benefit,… more
- Sedgwick (Greensboro, NC)
- …Adjuster - Mid Atlantic Region **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address most ... and non-complex National Accounts. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines claim forms and other records to determine insurance coverage. +… more
- Robert Half Accountemps (Fayetteville, NC)
- … billing practices and excellent organizational skills. Responsibilities: * Review and process medical claims with accuracy and attention to detail. * Verify ... billing. * Resolve discrepancies and follow up on denied claims to maximize reimbursement. * Maintain compliance with state...role within the healthcare industry. * Strong knowledge of medical billing procedures and insurance claim processes.… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …the health insurance industry, products and services + Familiarity with claims and claims processing. + NYS WC claim processing a plus + Strong follow-up, ... specific policies and procedures. Partner with Provider Contracting, Sales, Medical Management and Operations Department in identifying and resolving provider… more
- Cardinal Health (Raleigh, NC)
- …Practice Operations Management oversees the business and administrative operations of a medical practice. The Revenue Cycle Management team focuses on a series of ... distributing, and managing all billable services for reimbursement to the medical facility. This role works directly with insurance companies, healthcare providers,… more