- Rady Children's Hospital San Diego (San Diego, CA)
- …& process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is responsible ... for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans nationally… more
- University of Utah Health (Murray, UT)
- …Maintains accountability for customer service performance expectations. + Explains adjudication of claims for allocation of deductibles, co-pays, co-insurance ... and follows up on issues if needed. + Resolves problems resulting from claim adjudication and customer service phone calls. + May monitor and answer customer service… more
- Robert Half Office Team (Greenville, SC)
- …* Manually correct system-generated errors with high precision prior to final adjudication . * Process medical claims in compliance with provider contracts, pricing ... medical claims administration, including familiarity with billing functions and claim adjudication . * Experience with EHR systems such as Allscripts, Cerner… more
- US Army Reserve Command (Ames, IA)
- …If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the ... USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA… more
- National Park Service (Van Horn, TX)
- …Citizenship required. Appointment subject to background investigation and favorable adjudication . Meet Selective Service Registration Act requirement for males ... applicant's successful completion of a background security investigation and favorable adjudication . Failure to successfully meet these requirements will be grounds… more
- HUB International (Chicago, IL)
- …and anomalies related to pricing, formulary compliance, and proper adjudication . Financial Reconciliation: Verify the accuracy of financial guarantees, payments, ... (advanced functions) and SQL. + Familiarity with PBM platforms and claims adjudication systems. + Strong understanding of pharmacy billing and operational practices.… more
- NTT DATA North America (Plano, TX)
- …in Plano, Texas (US-TX), United States (US). Roles and Responsibilities: * Process Adjudication claims and resolve for payment and Denials * Knowledge in handling ... guidelines Requirements: * 1-3 years of experience in processing claims adjudication and adjustment process * Experience in professional (HCFA), institutional (UB)… more
- Billings Clinic (Billings, MT)
- …* Processes complete prescription claims including proper adjudication /reconciliation, insurance verification, prior authorization, and compassionate care/medication ... claims billing. * Enters medication charges and credits for the adjudication /reconciliation of patient accounts and insurance claims billing. * Participates in… more
- State of Massachusetts (Boston, MA)
- …and completely and that the determination (s) confirm that proper adjudication procedures have been followed throughout the determination process to ensure ... educational counseling, credit collection, credit interviewing, credit investigation, claims adjudication , claims settlement, claims examining, claims, investigation, claims interviewing,… more
- Catholic Health Services (Centereach, NY)
- …EMR platforms Experience with retail pharmacy prescription processing and claims adjudication Prior experience on pharmacy dispensing systems and familiar with ... insurance adjudication processes This role involves working with a broad array of complex disease states and medical conditions. Candidates should be comfortable… more