- HUB International (Chicago, IL)
- …of Pharmacy Benefit Managers (PBMs) to ensure contractual compliance, accurate claims processing, and proper financial management. This role involves in-depth data ... Audits: Plan, execute, and manage all aspects of PBM audits, including claims data analysis, financial reviews, and compliance checks against contract terms.… more
- Kemper (Downers Grove, IL)
- …or Bachelor's Degree Preferred + Understanding of auto coverage for non-standard claims is a plus + Various States experienced with auto claims handling ... professional with the ability to investigate and adjust first-party and third-party automobile claims . We are offering the opportunity to work in a fast-paced and… more
- System One (Reston, VA)
- …and deliver training for diverse audiences-including Customer Service Representatives, Claims Processors, and Enrollment staff-focused on claims , enrollment, ... alignment with business objectives and process updates. + Support learners on claims , enrollment, and benefits processes to ensure accuracy in servicing members and… more
- LogixHealth (Dania Beach, FL)
- …benefits (EOB) statement + Analyze A/R (Accounts Receivable) reports to follow up on unpaid claims + Send out appeals on claims that require an appeal + Submit ... required documentation to insurance companies as requested + Research claims for information in order to process bills in a timely manner + Communicate with… more
- DR Horton, Inc. (Arlington, TX)
- …Responsibilities*include the following. Other duties may be assigned. * Research background of claims * Monitor status of claims and update litigation database * ... Respond to subpoenas, garnishments, subrogation, property damage and pre-litigation claims * Coordinate information collection between outside counsel and divisions… more
- Sharp HealthCare (San Diego, CA)
- …service, medical billing, patient services, member services, patient accounting or claims processing. ** Preferred Qualifications** + HS Diploma or Equivalent ... center environment. + Certified Revenue Cycle Representative (CRCR) - HFMA - PREFERRED + Certified Specialist Managed Care (CSMC) - Healthcare Financial Management… more
- Walmart (Milford, OH)
- …Manages facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of policiesprocedures ... Determines training needs Develops and delivers training as needed Manages claims and receiving operations by ensuring proper policies and procedures are… more
- Novant Health (Winston Salem, NC)
- …You will also handle patient inquiries regarding their accounts and resubmit claims as needed to ensure accurate reimbursement. Key Responsibilities: + Follow up ... on unpaid or denied insurance claims with no payer response. + Analyze patient accounts...Diploma or GED, required. 2 Year / Associate Degree, preferred . + Experience: Minimum two years in medical billing… more
- Molina Healthcare (Louisville, KY)
- …rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate ... for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounter data and develops recommendations based on data and industry… more
- Zurich NA (Schaumburg, IL)
- …including an Associate Degree and 12 or more years of experience in the Claims or Underwriting Support area Preferred Qualifications: + Bachelor's Degree or ... work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while gaining… more