- CareFirst (Baltimore, MD)
- …score methodology, risk score calculation, enrollment, premiums, medical and pharmacy claims , and provider data. Incumbent is responsible for performing complex ... the Company, as well as external entities, providing coordination and support as required. **ESSENTIAL FUNCTIONS:** + Accurately monitor and reconcile submitted… more
- Humana (Oklahoma City, OK)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... investigations into allegations of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud… more
- Zurich NA (Fresno, CA)
- …+ Work to have a timely resolution to matters by collaborating with the claims adjuster, developing a case strategy and escalating issues as appropriate. + Ensure ... a technical resource by providing guidance and mentoring lower level attorneys or legal support staff on use of tools and resources and legal strategies. + Protect… more
- Steele County (Owatonna, MN)
- …office: o Determines information needed for invoice preparation of health care claims to multiple billing sources, coordinates with professional staff to obtain ... o Invoices private pay billings for home care services. o Monitors claims and researches billing related problems through coordination with professional staff, third… more
- Humana (Columbus, OH)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and… more
- Fifth Third Bank, NA (Grand Rapids, MI)
- …previously filed dispute. This may include specialized disputes, including denied claims , reassertions, repeat offenders, and Private Bank client customers. The ... Commercial Code (UCC) and Regulation E and Regulation Z claims . The Analyst uses various bank and vendor systems...Disputes, Fraud, Banking, or a related field preferred. + Associate 's degree or equivalent work experience. Fluent in English… more
- Robert Half Finance & Accounting (Rocky Mount, NC)
- …In this role, you will ensure accurate and timely processing of customer claims and payments while maintaining strong relationships with internal teams and external ... equipment manufacturing industry. Responsibilities: * Update and track customer claims daily to ensure accurate status monitoring. * Communicate effectively… more
- Florida Crystals Corporation (Baltimore, MD)
- …consensus standards. + Provide relevant content and subject matter expertise to support : + Required safety related training + Effective implementation of safety ... programs + The prevention of accidents through incident investigations, site assessments, associate communication and data analysis + Define plant safety goals to… more
- Henry Ford Health System (Troy, MI)
- …HAP code-related committee meetings to resolve coding questions related to claims , configuration, benefits, new technology, fraud, compliance, and any other issue. ... Aside from committee meetings, assist with claims resolution issues as needed. + Assist in requesting and tracking any system configuration changes completed by the… more
- OhioHealth (Orient, OH)
- …and in our communities. **Job Description Summary:** Provides receptionist/clerical support assuring patient flow, comfort and satisfaction. Primary responsibilities ... (EMR) system, data entry of patient information and insurance verification, providing support to staff members as assigned. The Office Specialist is well organized,… more