- US Tech Solutions (Richmond, VA)
- …efficiency involving clinical issues Facilitates optimal outcomes. Identifies and follow through with continuous quality/ compliance opportunities . Educates/ ... including co-morbid and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case management and eligibility.… more
- University of Virginia (Charlottesville, VA)
- …documentation. + Reviews and resolves charge sessions that fail charge review edits, claim edits and follow -up work queues, identifies areas of opportunity based ... depending on their work assignment. + Reviews documentation in medical record to appropriately assign ICD-10-CM, CPT-4, HCPCS and...of errors. + Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate… more
- Datavant (Richmond, VA)
- …Radiology Cardiology Injection and Infusion services Orthopedics Post-operative pain blocks Medical necessity documentation Claim edits and revenue codes ... Radiology Cardiology Injection and Infusion services Orthopedics Post-operative pain blocks Medical necessity documentation Claim edits and revenue codes… more
- Intermountain Health (Richmond, VA)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing, denials, payments, customer service, and follow up ... Process + Communication + Insurance Processing and Issues + Medical Terminology + Claims Processing + Collaboration...personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe… more
- CenterWell (Richmond, VA)
- …+ Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations. + Medication adherence outreach, auditing, ... + Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan limitations,… more
- Sumitomo Pharma (Richmond, VA)
- …(https://c212.net/c/link/?t=0&l=en&o=4190475-1&h=3440496098&u=https%3A%2F%2Fwww.us.sumitomo-pharma.com%2F&a=https%3A%2F%2Fwww.us.sumitomo-pharma.com+) or follow us ... company's new and established programs. This position reports to the Chief Medical Officer. **Job Duties and Responsibilities** + Strategic thought partner including… more
- Intermountain Health (Richmond, VA)
- …an overall goal of account resolution. + Abel to navigate various payer claim portals and understand payer functionality. + Interacting with others by effectively ... English. **Skills** + Recognizing true overpayments from false credits + Researching claim cycle + Understanding Coordination of Benefits + Understanding EOB +… more
- Sedgwick (Alexandria, VA)
- …stewardship and other reports. + Coordinates client invoicing, audits and accounts receivable follow -up for assigned clients. + Educates the client on loss data - ... in one of the following areas: workers compensation, liability and disability claims management + Strong understanding of client location coding parameters, banking… more
- University of Virginia (Charlottesville, VA)
- …the Central Billing Office has assigned AR responsibility. + Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined ... Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities...from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and… more
- General Dynamics Information Technology (Fairfax, VA)
- …Trusted Third Party activities. **Roles and Responsibilities** + Reviews and analyzes medical claims to determine accuracy, completeness and compliance with ... reimbursement criteria. + Verifies the accuracy of diagnosis and procedure codes in claims data, ensuring alignment with medical policies and industry coding… more