- Molina Healthcare (KY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide ... daily investigative activities as a back-up to the SIU Manager . This position will be accountable for tracking on...utilization by providers and recipients. The position will review claims data, medical records, and billing data from all… more
- Covenant Health Inc. (Knoxville, TN)
- …updates. Communicates to Director or Revenue cycle and/or CBO Operations Manager so information can be distributed to proper departments/staff. + Maintains ... as assigned to the satisfaction of the CBO Operations Manager and/or Director of Revenue Cycle. + Does not...staff for correction of charge entry errors. + Analyzes claim denials, looking for trends. Investigates errors. Reports findings… more
- State of Colorado (Denver, CO)
- …from inception through hearings and appeals, including fully contested claims , challenges to specific disability and medical benefits, penalty allegations, ... Workers' Compensation Division, state agencies, and the State's third party- claims administrator, regarding workers' compensation law, liability exposure, and… more
- FirstBank PR (San Juan, PR)
- …throughout the Corporation on HR programs, policies and procedures related to claims ' investigations as well as disciplinary actions and the applicable laws and ... risks and litigation. This position includes within its scope: claims ' investigations, change and conflict management, overseeing of performance improvement… more
- The County of Los Angeles (Los Angeles, CA)
- …Assistant I. Essential Job Functions Analyzes and makes recommendations to the unit manager for the resolution of problems of work procedure and space allocation; ... reports and projections of workload and staffing for the manager of the unit. Coordinates and resolves problems between...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be… more
- AdventHealth (Tampa, FL)
- …opportunities for increased revenue. + Coordinates with insurance providers to resolve claim issues, negotiate settlements, and ensure timely payments. + Reviews and ... processes insurance claims , ensuring accuracy and compliance with regulatory requirements. **Knowledge,...Revenue Cycle Rep (CRCR) [Preferred] + Certified Healthcare Access Manager (CHAM) [Preferred] **The expertise and experiences you'll need… more
- KDG Construction Consulting (Los Angeles, CA)
- …compliance. Responsibilities and Duties: + Collaborates with the Project Manager regarding disposition of contractual issues + Preparing Contractual Correspondence ... + Facilitate the meriting process of all potential change claims made by contractors, ensuring all appropriate subject matter...ensuring all appropriate subject matter experts have reviewed the claim + Assembling Task Orders and Change Orders +… more
- Geisinger (Danville, PA)
- …providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and ... physician queries. + Assists the Coding Quality and Professional Manager with training of new coding staff related to...and corrects historical file data by completing and submitting claim action reports per the PHC4 quarterly report. +… more
- HUB International (Wilmington, MA)
- …experience and in-depth knowledge of insurance markets, policy provisions, claim processes, business environment, and risk mitigation, applies independent and ... discretionary judgment to make decisions independent of manager approval on books of insurance business for which the incumbent is responsible. These include… more
- Perdue Farms, Inc. (Salisbury, MD)
- …associates within the order management group, including logistics, data maintenance and claims management. The salary range for this position is $56,000.00 - ... sales specific functions such as book features, prepare market request, process claim forms and payments, review broker commissions, and resolve deductions all in… more