- LA Care Health Plan (Los Angeles, CA)
- …courteous manner. Perform other duties as assigned. Duties Continued Education Required Associate 's Degree in Nursing Education Preferred Bachelor's Degree in ... Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …Specialist II will be responsible for reviewing, submitting, and tracking claims for VOALA-s Health Supportive Services division, consisting of Community Supports ... CalAIM program inclusion. The role will monitor assigned CS and ECM program claims for errors and flag appropriate parties for billing corrections. The CalAIM… more
- Humana (San Juan, PR)
- …**Key Responsibilities:** + Lead large-scale product efforts focused on improving claims processing and related systems, ensuring these efforts support Humana's ... and measurable value realization, especially when navigating complex, high-volume claims environments. + Partner closely with architecture, operations, compliance,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Consultant works with a wide variety of stake holders to analyze high-cost claims and members, evaluate clinical trends, and formulate business proposals to mitigate ... while collaborating with various business units including teams across HMM, Sales, Claims Operations, Finance, and Legal. * This position is eligible for the… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up...business experience, preferably in a healthcare setting; **or** an Associate 's degree and at least 6 months of business… more
- Kemper (Doral, FL)
- …to the public. + Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or ... conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the...Certified Fraud Examiner (CFE) designations are preferred . + A valid driver's license and clean driving… more
- GE Appliances, a Haier company (Louisville, KY)
- …+ Support case and document management for insurance and direct claims , workers' compensation, administrative, regulatory, and investigatory matters, as well as ... + Track the status, deadlines, and budgets for assigned cases and claims . + Manage document preservation, collection, and production in coordination with counsel.… more
- Tidelands Health (Myrtle Beach, SC)
- …reimbursement of service rendered and to maintain an industry standard clean claim rate. **What you will do** + Analyze medical records, interprets documentation, ... and verify all information required to produce a clean claim including special billing procedures that may be defined...in Orthopedics or OB/GYN Required + Experience working remotely Preferred **Skills and Abilities** + Basic knowledge of ICD… more
- Tufts Medicine (Tyngsboro, MA)
- …(2) years of experience in revenue cycle, medical billing and/or cash posting ** Preferred Qualifications:** 1. Associate 's Degree 2. Epic Experience **Duties and ... duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted … more
- Zurich NA (Madison, WI)
- …School Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an ... Associate Degree and 3 or more years in the...and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft… more