- CVS Health (Boise, ID)
- …review a clinical determination and understand rationale for decision. + Able to research claim processing logic and various systems to verify accuracy of claim ... efforts both internally and across departments to successfully resolve claims research, SPD/COC interpretation, letter content, state or federal regulatory… more
- New York State Civil Service (Menands, NY)
- …with general or claim -specific information as applicable. Responding to claim -specific questions may require reviewing and processing claims , performing ... Appointment Type Permanent Jurisdictional Class Competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 37.5 Workday From 7 AM To 5 PM Flextime… more
- Aflac (Shelton, CT)
- …on state regulations. + Coordinates correspondence, forms, and other documents via the claim system; documents the claims system in an accurate and comprehensive ... Makes timely, accurate, and customer-focused new and ongoing Absence Management claim decisions; reaches out to obtain relevant healthcare provider, employer,… more
- Ventura County (Ventura, CA)
- …degree each pay period. + Executive Annual Leave: The selected candidate will earn 248 hours per year, increasing to 288 hours after 5 years of service, 328 ... hours after 10 years of service, and 368 hours after 15 years of service. Credit for prior...exposure. It also involves overseeing all aspects of the claims process for the County's self-insured programs, from initial… more
- CVS Health (Phoenix, AZ)
- …working with insurance companies to resolve issues associated with our patients' insurance claims . In this role you will ensure timely follow-up on all patient ... accounts, identify and prepare adjustments and write-offs; correct and resubmit claims (subject to policy); follow-up on daily correspondence (denials, short-pays);… more
- Kestra Medical Technologies, Inc (Kirkland, WA)
- …manage assigned payor accounts to ensure timely follow-up and resolution of outstanding claims . + Analyze payor trends and denial patterns to identify root causes ... improvements. + Communicate effectively with insurance companies to resolve claim issues, including denials, underpayments, and rejections. + Coordinate capably… more
- Elevance Health (Carroll, IA)
- …Relations Consultant, West Iowa** **Location:** Carroll, Iowa and surrounding counties ** Hours :** Standard M - F **Field:** This field-based role enables associates ... + Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices. + May participation in… more
- US Tech Solutions (Columbia, SC)
- …medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. + Monitors process's ... training)** **Duration: 3+ Months Contract** **(Possible extension)** **Job Description:** + Hours /Schedule: Monday - Friday, 8:30am-5pm. + Onsite training for the… more
- US Tech Solutions (Columbia, SC)
- …medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. Monitors process's ... training)** **Duration: 3+ Months** **(Possible temp to hire)** **Job Description:** + Hours /Schedule: Monday - Friday, 8:30am-5pm. + Onsite 1-2 weeks, then will… more
- CVS Health (Sacramento, CA)
- …review a clinical determination and understand rationale for decision. Able to research claim processing logic and various systems to verify accuracy of claim ... Serves as point person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as well as other… more