- 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
- The County of Los Angeles (Los Angeles, CA)
- …employer's name and address, job title, beginning and ending dates, number of hours worked per week, and description of work performed. We may verify information ... steps to view correspondence, and we will not consider claims of missing notices to be a valid reason...of Employment: From (mm/dd/yy) - TO (mm/dd/yy) *Number of hours worked per week *Duties performed Please ensure the… more
- Commonwealth of Pennsylvania (PA)
- …System (WCAIS) to maintain a caseload, process tasks, and distribute correspondence for claims . You will have the opportunity to correspond with the public by phone, ... Schedule and Additional Information: + Full-time employment + Work hours are 8:00 AM to 4:30 PM, Monday -...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
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