- University of Rochester (Rochester, NY)
- … to obtain and verify insurance coverage. Follows up on unpaid accounts working claims . Reviews reasons for claim denial. Reviews payer website or contacts payer ... 14642 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours : 40 Department: 500011 Patient Financial Services Work Shift: UR - Day… more
- Allied Universal (Orange, CA)
- 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)
- …Qualifications:** + Advanced experience with Epic Resolute PB/HB for managing high-balance A/R and claim edits. + Skilled in Epic Claim Edit Work queues, Error ... Pool, and Routing Logic for clean claim submission. + Proficient in Epic EDI Gateway workflows...be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional… more
- Sedgwick (Columbus, OH)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... the claims management system. + Assigns new claims to the appropriate claim 's handler. +...or management as needed. + Attendance during scheduled work hours is required. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
- Commonwealth of Pennsylvania (PA)
- …1 responsible for researching, analyzing and processing complex unemployment overpayment claims issues. If you are a detail-oriented professional with a commitment ... Regulations as you analyze and facilitate resolution of complex claim issues, review overpayments for technical accuracy and prepare...Schedule and Additional Information: + Full-time employment + Work hours are 8:00 AM to 4:00 PM, Monday -… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …to prevent fraud and ensure compliance with policy terms. + Resolve Rejected Claims : + Calculate benefit payments and approve claim settlements based on ... SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and maximum payer reimbursement. They prioritize… more
- Commonwealth of Pennsylvania (PA)
- …will help us oversee the adjudication process and handle disputes about workers' compensation claims . If you are looking for a new and rewarding way to utilize your ... Schedule and Additional Information: + Full-time employment + Work hours are 8:00 AM to 4:00 PM, Monday -...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Aflac (Farmington, CT)
- …ongoing claim decisions on moderately complex to highly complex claims using advanced independent discretion guided by company procedures and regulatory ... be successful in this role? * Strong understanding of disability claims management concepts. * Solid understanding of medical terminology/pathology/anatomy. *… more
- JBS USA (Greeley, CO)
- …and determine if the parties involved have provided the required information to process a claim . Aid in any litigation of claims . + Work with IT in regards ... Unit. This role will manage a team of 10 to include Customer Service, Claims , and Deductions. Responsibilities: + Be able to work with limited supervision to… more
- Commonwealth of Pennsylvania (PA)
- …and issue official correspondence. Your role also includes reviewing Workers' Compensation claims for accuracy and system entry, as well as assisting with ... Work Schedule and Additional Information: + Full-time employment, 37.5 hours per week + Work hours are...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
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