- Prime Healthcare (Farmers Branch, TX)
- …and plans of reach / exceeding key performance indicators (KPI) relating to billing operations , which include but are not limited to: 837 files, billing edits, clean ... claim rate standards, billing errors and trends, as well as claim rejections and trends. Through strategy development, aligning the annual initiatives and… more
- Sonora Quest (Phoenix, AZ)
- …health! **POSITION SUMMARY** This position coordinates and facilitates all insurance claim submissions, claim rejections, account refunds, complex adjustments ... professional standards._ **MINIMUM QUALIFICATIONS** + Two (2) years' medical claim collection experience with knowledge of insurance billing requirements and… more
- HCA Healthcare (Nashville, TN)
- …--Employer and employee cost share + Provide consulting services to claims administrators concerning plan provisions, operations and benefits administration ... health and welfare plan to ensure highest level of employee benefits operations delivery. Resolve elevated issues relative to benefit plan interpretation and… more
- Otsuka America Pharmaceutical Inc. (Montpelier, VT)
- …to support development, planning, and implementation of the S&OP (Sales & Operations Planning) process. You will support execution of global sourcing strategies ... / project manager, product development, new product introduction, technical operations , site quality and pharmaceutical development internal/external manufacturing teams.… more
- The County of Los Angeles (Los Angeles, CA)
- …on employee benefits. The team member we are searching for: Directs the operations of a medium-sized community library or performs more difficult and specialized ... more community libraries, as needed. Community Libraries Directs the operations of a medium-sized community library or serves as...steps to view correspondence, and we will not consider claims of missing notices to be a valid reason… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …Assist in billing and cash application of Medicaid/Medicare/DME/Home Infusion claims . Manage open accounts receivable which requires rebilling within timely ... Duties:** + Manual billing and payment application for secondary insurances, Noble Medical Billing Claims , home infusion claims , and DME claims + Oversight… more
- Humana (Oklahoma City, OK)
- …role will require critical thinking/problem solving skills, understanding of health plan operations , and strong interpersonal skills. Key Role Objectives + Serve as ... issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate… more
- Molina Healthcare (Miami, FL)
- …Governance and Operations Reviews + Performs root cause analysis of claims and encounter data and develops recommendations based on data and industry knowledge. ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- Command Investigations (Detroit, MI)
- …premier servicer for insurers and defense attorneys throughout Michigan, and our Assigned Claims Plan (ACP) unit is actively expanding to meet the increasing demand ... clients handling medical, wage loss, attendant care, replacement service and survivorship claims generated through the Michigan Assigned Claims Plan (MACP). We… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors ... periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality control reviews, internal… more
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