- Commonwealth of Pennsylvania (PA)
- …Schedule and Additional Information: + Limited term, full time employment, 37.5 hours per week. + Limited-term, full-time wage position with benefits (Bronze Plan). ... possible extension for an additional 6 months. + Work hours are 3:00 PM to 11:00 PM, with a...Select the "Level of Performance" which best describes your claim . + I have experience sorting, filing, and retrieving… more
- Commonwealth of Pennsylvania (PA)
- …. Work Schedule and Additional Information: + Full-time employment, 40 hours per week + Work hours are 7:30 AM ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....Select the "Level of Performance" which best describes your claim . + A. I have provided vocational training in… more
- Essentia Health (Superior, WI)
- …nursing staff, pharmacies, third parties, and software vendors to work through claims adjudication and processing issues to ensure payment from third-party payers ... help ensure Medicare rules are followed when processing Medicare B billed claims + Provide direct patient interaction by assisting patients with manufacturer-based… more
- Molina Healthcare (Columbus, GA)
- **JOB DESCRIPTION** **This role will have standard EST business hours .** **Job Summary** Provider Network Administration is responsible for the accurate and timely ... validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of… more
- CVS Health (Harrisburg, PA)
- …review a clinical determination and understand rationale for decision. * Able to research claim processing logic and various systems to verify accuracy of claim ... person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as...1 years of experience in research and analysis of claim processing. - 1-2 years Medicare part C Appeals… more
- TEKsystems (Baltimore, MD)
- …account balances utilizing Patient Accounting software (EPIC) -Timely submission/transmission of claims and verification of claim acceptance where appropriate ... at least 2-3+ years of Medicare Billing experience -Must have knowledge of claim submission/denials process -EPIC experience a plus Job Description -Will be focused… more
- AdventHealth (Tampa, FL)
- …guidelines and managed care contracts. Responsible for receiving and addressing accounts within 72 hours of being routed to the claims edit work queue and coding ... billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight...**ue you'll bring to the team:** Review and analyze claim denials to perform the appropriate resolution, rebilling, and/or… more
- State of Montana (Helena, MT)
- …Montana. This is a part time position that will be required to work a minimum of 20 hours per week. Typical work hours are expected to be between 20 to 30 ... hours per week and may be increased as needed...the objectives of the stakeholders. Such as processes all claims and grants and facilitating LLB meetings. * Assess… more
- CVS Health (Hartford, CT)
- …Medicare pricing methodologies and contracts, various Medicare Advantage claim policies, ClaimsXten/Cotiviti edits, Utilization Management and Provider Demographics. ... business requirements into test scenarios to validate configurations and associated claim adjudication logic. + Trouble-shooting (HealthRules Payer) HRP repair edits… more
- Penn Medicine (Philadelphia, PA)
- …reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution. Responsibilities: + Responsible for ... Location: Penn Presbyterian Medical Center- 51 N 39th Street Hours : Full Time Summary: + The Account Resolution Specialist...position will work out of assigned work queues handling claim edit work queue resolution as well as follow… more