- 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
- Trinity Health (Albany, NY)
- …reconciliation daily. + Report any outstanding claims to contact to ensure all claims are billed timely + Review each claim for appropriate information. + ... required but a plus. **Responsibilities:** + Responsible to monitor and resolve Claims Work queues, Specifically Front End, Referrals & Authorizations, and Clinical… 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
- ArcBest (Mount Vernon, WA)
- …* Exhibit excellent customer service * Assist in collection process and cargo claim prevention, as needed * Other duties and projects, as assigned Requirements ... Education: * Bachelor's Degree, preferred * Relevant experience will be considered. Experience: * Transportation industry and related sales experience, preferred Computer Skills: * Proficient in Microsoft Office Suite. Certifications: * Current and legal… more
- Military Sealift Command (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
- Centene Corporation (New York, NY)
- …relationships to maintain/improve provider satisfaction, provide assistance in escalating claim issues, participate in provider meetings/JOCs, delegate work, hire / ... interview staff, train and provide development opportunities for staff, and manage projects and ad hoc requests accordingly. This role will support the Provider Engagement Operating Model (PEOM), an enterprise strategic priority focused on driving provider… more