- Cognizant (Frankfort, KY)
- …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was...of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality… more
- Sedgwick (Frankfort, KY)
- …growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Best Workplaces in Financial Services & Insurance General Liability Claims Examiner | Dedicated Client | Remote ... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting… more
- Cognizant (Frankfort, KY)
- …* 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must ... Based on this role's business requirements, this is a remote position open to qualified applicants in the United...ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:**… more
- Sedgwick (Frankfort, KY)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner Workers Comp I Remote I SE, Central, NE regions **PRIMARY ... PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving… more
- Molina Healthcare (Lexington, KY)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery,… more
- HCA Healthcare (Bowling Green, KY)
- …Do you want to join an organization that invests in you as a Medical Insurance Claims Specialist? At Parallon, you come first. HCA Healthcare has ... make a difference. We are looking for a dedicated Medical Insurance Claims Specialist like you to...Follow up Representative** , you will be responsible for processing insurance accounts to address claim issues and thereby… more
- Sedgwick (Frankfort, KY)
- …growth, and inclusion. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... thinking ability; excellent judgement and discretion; ability to meet deadlines. \# claims #claimsexaminer # remote Sedgwick is an Equal Opportunity Employer… more
- Elevance Health (Louisville, KY)
- …The **Clinical Document Improvement Director** is responsible for leading encounter processing , diagnostic documentation and claims integrity across CareBridge. ... be considered. This position will work a hybrid model ( remote and office). The ideal candidate will live within...cycle management (RCM) organizations, with specific understanding in end-to-end claims / encounter processing , as well as ensuring… more
- Guardian Life (Frankfort, KY)
- …MS Word/Excel/PP + College degree preferred or equivalent work experience + Claim processing experience preferred or working knowledge of claims processes + ... As the ** Claims Case Manager I** , **Supplemental Insurance,** you...corresponding type of service codes and benefit amounts for processing + Assess file to determine if benefits are… more
- Molina Healthcare (Louisville, KY)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more