- UPMC (Bridgeville, PA)
- UPMC Rx Partners is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides prescription data entry and ... adjudication of claims under the supervision of a licensed pharmacist. This...Partners Skilled nursing and Hospice clients. The clinical review specialist at Rx Partners works hand in hand with… more
- Stony Brook University (East Setauket, NY)
- Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the **Senior Revenue Cycle Specialist ** will act as an operational leader in the ... but are not limited to:** + Develops staff work listing logic/strategy and claims resolution work flows. + Educates and trains new staff regarding departmental/unit… more
- UPMC (Pittsburgh, PA)
- …the scenes to make sure things run smoothly and accurately? As a Document Process Specialist , you'll be at the front line of our claims intake process-ensuring ... in health insurance operations-all while contributing to the timely resolution of claims . You'll be responsible for accurately entering and validating high volumes… more
- Redeemer Health Home Care & Hospice (Philadelphia, PA)
- …We invite you to apply today. SUMMARY OF JOB The Account Receivable Specialist is responsible for performing resolution-oriented claims submission and follow-up ... need. RECRUITMENT REQUIREMENTS High school diploma or GED. Experience in medical billing or healthcare accounts receivable experience; medical billing coursework… more
- Henry Ford Health System (Jackson, MI)
- …obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new practices, and conducting audits ... Network. * Serves as the point of contact for Network practices to address claims issues with Network payors by troubleshooting on behalf of the practice and working… more
- Amergis (Columbia, MD)
- …staffing experiences to deliver the best workforce solutions. The Reimbursement Specialist I reviews branch sales for appropriate documentation, generate and bill ... claims and/or invoices, follows up on unpaid accounts, and...provides support and customer service to branch offices regarding billing concerns. Essential Duties and Responsibilities: + Processes and… more
- SERV Behavioral Health System (Hamilton, NJ)
- …life satisfaction through a wide range of services. JOB SUMMARY: The Accounts Receivable Specialist will follow-up on unpaid claims including denied and held ... claims , denial review and resolution, corrected claims , denial appeals, payment posting as requested, contractual write offs and other adjustments, secondary … more
- BrightSpring Health Services (Centennial, CO)
- …Providing service to all the Amerita locations, the PBM Payer Audit Specialist reviews audit request, compiles and classifies existing documentation and identifies ... documentation needed to respond effectively and efficiently. The PBM Payer Audit Specialist also performs quality assurance checks for all medical and PBM billing… more
- Molina Healthcare (Kenosha, WI)
- JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... ensure that internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise Act** cases… more
- BronxCare Health System (Bronx, NY)
- Overview Conduct review of denied claims and audits of registration/insurance verification activities to improve denial rates and enhance revenue. In-service staff ... analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality...to be kept up to date (Pre & Post Billing ). - Develops with Clinic Operations corrective action plans… more