- TEKsystems (Fairfax, VA)
- TEKsystems is actively hiring for Member Service Representatives ( Medicare ) for an independent non-profit health plan company based out of MN! (Fully remote ... eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims , payments, member reimbursement, and demonstrated knowledge of CAG policies,… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …(Palmetto GBA) and CMS web sites + Understanding of the CMS Publication: 100-4 ( Medicare Claims Processing Manual) + Ensures claim information is complete and ... The Medicare Billing and Follow-up Representative are...limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both… more
- TEKsystems (Fairfax, VA)
- …TIME REMOTE PURPOSE: Under direct supervision reviews and adjudicates paper/electronic claims . Determines proper handling and adjudication of claims following ... policies and procedures. ESSENTIAL FUNCTIONS: 60 Examines and resolves non-adjudicated claims to identify key elements of processing requirements based on contracts… more
- Humana (Lynchburg, VA)
- …caring community and help us put health first** The Provider Relations Representative (Provider Engagement Professional 2) is responsible for day-to-day front line ... including, where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals) + Work with internal… more
- Conduent (VA)
- …where individuality is noticed and valued every day. **Remote Call Center Representative ** We are seeking individuals who are passionate about helping others, ... average 30-40 calls per day. ** About the Healthcare Call Center Representative :** Manage a steady volume of incoming calls regarding Benefits, Enrollment,… more
- Cardinal Health (Richmond, VA)
- …the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Cardinal Health (Richmond, VA)
- …+ Acts as a subject matter expert in claims processing. + Processes claims : investigates insurance claims ; properly resolves by follow-up & disposition. ... account receivables performance and client satisfaction. + Resolves complex insurance claims , including appeals and denials, to...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Evolent (Richmond, VA)
- …+ Answer and manage inbound inquiries regarding health plan benefits and claims , eligibility, medical and other healthcare procedures, billing and payments and other ... and verbalize processes and procedures of the organization and of health insurance coverage. + Training includes a virtual classroom environment with trainers who… more
- AbbVie (Roanoke, VA)
- …order to educate providers on payer issues, coding changes, and appropriate claims submission processes + Liaise with AbbVie's Access and Reimbursement support ... care + Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics + Strong understanding of drug acquisition and dispensing… more