- Mass Markets (Las Cruces, NM)
- …a fast-paced, dynamic environment + Excellent interpersonal skills and team collaboration Preferred Qualifications + Associate 's degree or higher + Experience in ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- Allied Universal (Dallas, TX)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- UTMB Health (Galveston, TX)
- …Experience with communicating, training, and educating providers in proficiency. ** Preferred Qualifications:** + Knowledge of coding guidelines, anatomy and ... **One of the following:** + CCA - Certified Coding Associate (AHIMA) _or_ + CCS - Certified Coding Specialist...procedures. + Sequences diagnoses and procedures to generate clean claims in accordance with the Coding Guidelines based on… more
- CVS Health (Trenton, NJ)
- …. + Clinical background a plus. + Experience with Aetna and CVS products, claim systems, and digital member applications. + Associate degree or equivalent work ... as well as navigating them through the health system, providing support on claims issues, and answering coverage-level questions. **We have two of these roles to… more
- CareFirst (Baltimore, MD)
- …measure capture and proper use of CPT and ICD 10 codes in claims submissions. Utilizes extensive coding knowledge, combined with medical policy, credentialing, and ... to maximize quality payments and risk adjustment. Translates from claim language to services in an episode or capitated...proactive training events or just in time on complex claims matters. Consults with various teams, including the Practice… more
- Rush University Medical Center (Chicago, IL)
- …benefit plans. The role ensures accurate, timely, and compliant claim submission, follow-up, and collections, while managing high-dollar, high-complexity accounts ... requirements. **Responsibilities** + Prepares and submits outpatient pharmacy (home infusion) claims covered by medical on a weekly basis. + Analyzes, resolves,… more
- Rush University Medical Center (Chicago, IL)
- …statements. The Specialty Billing Representative processes and follows up on claim denials, underpayments, and overpayments to ensure appropriate resolution and ... patient balance collections. **Responsibilities** + Prepares and submits medical claims weekly for Oncology, Infertility, Cystic Fibrosis, Transplant, and Pulmonary… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …coder (COC) preferred + Proficiency in working with and analyzing claims data + Strong written and verbal communication skills + Knowledge of CPT/HCPCS ... impacts, inquiries and implementation efforts. + Assist in developing new facility claim editing logic and maintenance of existing facility rule logic to support… more
- CVS Health (Columbus, OH)
- …Care experience + Spanish speaking/bilingual + Oncology experience/background **Education** Associate 's with RN licensure, required; BSN, preferred **Anticipated ... including co-morbid and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case management and eligibility.… more
- CVS Health (Jefferson City, MO)
- …PowerPoint, Excel, and Word. + Strong telephonic communication skills. **Education** + Associate 's degree in nursing required. + BSN preferred . **Anticipated ... including co-morbid and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case management and eligibility.… more