- Highmark Health (Dover, DE)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... ** Company :** Highmark Inc. **Job Description :** **JOB...and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES**… more
- Robert Half Accountemps (Rochester, NY)
- …accounts receivable processes and collection strategies. * Expertise in appeals and claim administration to address denied claims effectively. * Advanced skills ... role in managing billing operations and ensuring accurate processing of medical claims . This opportunity is ideal for professionals with a strong background in… more
- Access Dubuque (Dubuque, IA)
- …under ADA, state, and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims or makes a recommendation ... Galleria Officentre Southfield MI 48034 **PRIMARY PURPOSE** **:** To process claims and determine accommodation options following written guidelines and procedures… more
- Access Dubuque (Dubuque, IA)
- …under ADA, state, and/or client requirements for a qualifying condition. * Makes claim determinations to approve non-complex ADA claims or makes a recommendation ... Ingenuity Dr Orlando FL 32826 **PRIMARY PURPOSE:** To process claims and determine accommodation options following written guidelines and...Location Dubuque, IA Job Type Employee Full/Part Full Time Company ID 8326 Job REQ # R66424 \# Positions… more
- Access Dubuque (Dubuque, IA)
- …PURPOSE** The Senior Disability Representative is responsible for overseeing complex disability claims with a high level of autonomy and expertise. This role ... benefits eligibility, process timely payments and approvals, and manage claims involving comorbidities, concurrent plans, and ADA accommodations. The position… more
- Sedgwick (Sun Prairie, WI)
- …litigation support to the legal department; to prepare status reports related to claims against the Company ; to conduct initial investigation of claims ... reports to assist legal counsel in analysis of E&O claims to meet client specific, program or company...utilizing information technology to obtain information regarding the underlying claim . + Assists with reporting appropriate claims … more
- Access Dubuque (Dubuque, IA)
- …Representative **PRIMARY PURPOSE** : To provide disability case management and claim determinations based on complex medical documentation and the applicable ... and making timely payments/approvals and adjustments, medically managing disability claims ; coordinating investigative efforts, thoroughly reviewing contested claims… more
- Trinity Health (Davenport, IA)
- …of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates ... objective of maximizing reimbursement for services rendered and ensuring claims are paid or settled in a timely and...or settled in a timely and accurate manner. Researches claim rejections, make corrections, take corrective actions, and/or refer… more
- Waystar (Atlanta, GA)
- …The goal of the position is to ensure implementation clients exceed clean claim targets and report high satisfaction with Waystar edit processes and content. This ... product, client support and technical teams to deliver accurate, timely claim edit/authorization rule configurations. * Studying healthcare industry standards and… more
- Raphael and Associates (New York, NY)
- …30+ lbs.) Company Overview: Raphael & Associates is a third-party claims administrator and independent claims adjusting company internationally ... Adjuster to apply their knowledge of negligence theories while investigating Liability claims . This position provides an opportunity for the right candidate to… more