- Marshfield Clinic (Marshfield, WI)
- …Post High school courses in computer programming or software applications. ** Preferred /Optional:** Associate degree in business administration, computer sciences ... required. Knowledge of Wisconsin pharmacy law and third-party reimbursement rules. ** Preferred /Optional:** Three years' experience in pharmacy claims processing.… more
- Black & Veatch (Dallas, TX)
- …and EOR on solutions. Sometimes resulting in PCO/CO **Management Responsibilities** ** Preferred Qualifications** + Associate 's degree in a construction-related ... Verify materials/equipment and associated documentation for any stored materials claims + Verify that all other deliverables have been...discipline or craft apprenticeship preferred + At least 5-10 years field experience related… more
- Marshfield Clinic (Marshfield, WI)
- …and Accreditation._ **Minimum Required:** High school diploma or equivalent. ** Preferred /Optional:** Associate or Bachelor's Degree in business administration. ... claims processing. Demonstrated proficiency with customer service skills. ** Preferred /Optional:** One year experience in a Health Maintenance Organization (HMO)… more
- Humana (Columbus, OH)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates… more
- CareFirst (Baltimore, MD)
- …of financial business records, provider and subscriber medical data, claims , systems report, medical records, analysis of contract documents, provider/subscriber ... claims history, benefits, external data banks and other documents...and to preserve as potentially discoverable material. + Initiate claim adjustments, voucher deducts, and voluntary refunds in order… more
- Centene Corporation (Harrisburg, PA)
- …Purpose:** Conduct comprehensive reviews of medical records and documents supporting claims for providers, suppliers, and pharmacies to include but not limited ... overpayments and suspected health care fraud and abuse. Position requires the associate to verify authorization for services and written documentation of services… more
- Robert Half Office Team (Carmel, IN)
- …Specialist, where you will play a vital role in resolving denied medical claims efficiently and accurately in a fast-paced setting. Schedule: Monday through Friday, ... Responsibilities: + Review insurance denials and conduct thorough research to resolve outstanding claims . + Analyze patterns and trends in denied claims to… more
- Wawa, Inc. (IA)
- …a team of subject matter experts in insurance, finance, and casualty claims . Review and approve insurance requirements in company contracts and advise business ... proper execution of procedures through management of the insurance procurement and claims management for Wawa. Provide recommendations to the Sr. Director, QA, Risk… more
- Sedgwick (Richmond, VA)
- …university preferred . One or more of the following professional certifications is preferred : Graduate Safety or Associate Safety Professional (GSP or CSP), ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...with public entities, insurance, or risk pooling is highly preferred ; Candidate will need to conduct "site safety audits"… more
- Prime Therapeutics (Helena, MT)
- …Demonstrated organizational and time-management skills, with ability to work independently ** Preferred Qualifications** + Associate 's degree in business, health ... and documenting relevant information relating to the case in both the claims processing system and case management systems within pre-determined timelines + Act… more