- Amentum (Washington, DC)
- …complete review of our claims and the issuance of payment on those claims . Under the direction of VCF Correspondence Manager , Paralegal will perform the ... Generate outgoing daily correspondence using SOP template under supervision by the Correspondence Manager and Team Lead + Track and complete ad hoc and custom… more
- Access Dubuque (Dubuque, IA)
- …from some of the world's most respected brands + A **dedicated mentor and manager ** to guide you every step of your career journey + **Career development and ... based on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices. **ARE… more
- US Tech Solutions (Hershey, PA)
- …systems, as per company policy. + Acting as the Subject Matter Expert on work-related claims and claim statuses, collaboration with TPA claims adjusters and ... hours a week** **Main Duties:** + Reporting to the Manager , Occupational Health Nurse, and under the supervision of...to, physical therapists, specialists, and/or Nurse Case Managers. + Claims Management **Under the supervision of the physician or… more
- University of Rochester (Brighton, NY)
- …May research information to assist legal counsel + Produces reports, audits claim , evaluates eligibility and entitlements and considers multiple leave options to ... payments. + Exercises discretion and independent judgement when identifying claim discrepancies and recommends resolution processes. Directs vendors related to… more
- Quality Technology Services, LLC (Overland Park, KS)
- …who assist or participate in the investigation of any complaint or discrimination claim . The "Know Your Rights" Poster is included here: Know Your Rights (English) ... (http://www.eeoc.gov/sites/default/files/2022-10/22-088\_EEOC\_KnowYourRights\_10\_20.pdf) Know Your Rights (Spanish) The pay transparency policy is available here: Pay Transparency Nondiscrimination Poster-Formatted… more
- Commander, Navy Installations (Naval Base, VA)
- …when selecting individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit supporting documentation ... with your application as described in the Required Documents section below. more
- Mount Sinai Health System (New York, NY)
- …of the beneficiary, as coded and reported by the hospital on its claim , matches both the attending physician's description and the information contained in the ... beneficiary's medical record. Responsible for performing quality reviews of medical records to validate correctness and appropriateness of the assigned International Classification of Diseases, 10th Revision (ICD-10-CM and ICD-10-PCS) codes and the Diagnosis… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre\-certifications and appeals, ... utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility\. + Various immunizations and/or associated medical tests may be required for this position\. **Job Qualifications** _License_ + Current, active unrestricted Tennessee… more
- UnityPoint Health (Cedar Rapids, IA)
- …billing and denial issues, including sending appeals and trouble- shooting and correcting claim or account errors. + Documents denials and billing issues to identify ... processes that need improvement in order to maximize efficiency and ensure proper payment within the department. Daily and/or weekly duties: + Creates and modifies documents using word processing and spreadsheet computer programs. + Maintains designated filing… more
- Ascension Health (Pittsboro, IN)
- …Develop, implement and manage risk management activities. + Manage event and claim investigations, management and litigation across all coverage lines. + Serve on ... the appropriate hospital/ministry event reporting core team and Serious Event Review team(s). + Evaluate risk management functions and process through the use of data capture, follow up and trend analysis and present findings to appropriate committees;… more