- Select Medical (Camp Hill, PA)
- …discretion and secure information management. **Additional Data** **Your benefits as a Claims Resolution Specialist :** Select Medical strives to provide ... **Overview** ** Claims Resolution Specialist ** **Starting at $18.50...or Equivalent + One year of experience within a medical billing, medical collecting or claims… more
- Select Medical (Camp Hill, PA)
- **Overview** **Senior Claims Resolution Specialist ** **Starting at $18.50.00/hr but flexible for experienced candidates** Do you enjoy puzzles and research? Are ... you results-oriented? If so, our Claims Resolution Specialist position may be a...or Equivalent + One year of experience within a medical billing, medical collecting or claims… more
- Sedgwick (Harrisburg, PA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle ... more complex first and third party commercial insurance auto claims . JOB RESPONSIBILITIES + Evaluates each claim in light of facts; Affirm or deny coverage;… more
- Cognizant (Harrisburg, PA)
- …of claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support...HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered… more
- WellSpan Health (York, PA)
- …HCPCS and ICD-10 codes as well as modifiers. + Conducts reviews comparing medical record documentation to validate charge capture, medical necessity, and coding ... and work queues, due to potentially inappropriate documentation, coding, medical necessity or charge entry. Communicates with departments, including Compliance… more
- Commonwealth of Pennsylvania (PA)
- …Program Integrity is looking for a driven and detail-oriented Third Party Liability Specialist to help recover medical assistance expenditures. You will have the ... + Credits/Clock Hours 10 WORK BEHAVIOR 2 - INVESTIGATES PERSONAL INJURY CLAIMS AND THEIR ESTATES Investigates medical assistance recipients' personal injury… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding ... provider documentation and queries, coding software tools and Insurance carrier medical and reimbursement policies during the claim review process. JOB DUTIES… more
- Robert Half Accountemps (Doylestown, PA)
- …financial operations. * Understanding of billing forms and their application in medical claims processing. * Excellent communication and organizational skills to ... Description We are looking for a detail-oriented Medical Accounts Receivable Specialist to join...play a vital role in managing Medicare billing, insurance claims , and patient accounts to ensure the financial stability… more