- Johns Hopkins University (Middle River, MD)
- …III_** who will be responsible for the collection of unpaid third-party claims and independent resolution of complex appeals, using various JHM applications and ... Communicates with payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy denials and… more
- Robert Half Office Team (Plano, TX)
- …Texas. In this role, you will play a critical part in supporting claims processes within the financial services industry. This is a long-term contract opportunity ... skills and a commitment to accuracy. Responsibilities: * Perform thorough initial claim reviews to determine the appropriate application of coverage and assess the… more
- Methodist Health System (Dallas, TX)
- …to resubmit claims promptly and accurately. - Investigate and address claim denials promptly. Utilize knowledge of payor policies, medical coding guidelines, and ... background in A/R follow up for family and specialty claims , able to identify, address, and resolve no response...: - High School Diploma required - College degree preferred - Two to four years of experience in… more
- Independent Health (Buffalo, NY)
- …related phone calls. The COB Coordinator will also be responsible for basic claims adjudication, performing basic claim adjustments and working defined reports. ... interpret basic COB information as it relates to Independent Health's obligation for claim payment and follow New York State Rules & Regulations, NAIC Guidelines,… more
- Sedgwick (Eden Prairie, MN)
- …LTD Supervisor, LTD Manager, or Project Manager. + Negotiates settlement of appropriate claims within designated authority level. + Makes claim payments and ... Services & Insurance LTD Case Specialist **PRIMARY PURPOSE** **:** To analyze claims and determine benefits due ensuring compliance with plan provisions; to… more
- Sedgwick (West Hills, CA)
- …LTD Supervisor, LTD Manager, or Project Manager. + Negotiates settlement of appropriate claims within designated authority level. + Makes claim payments and ... & Insurance LTD Case Specialist (Hourly) **PRIMARY PURPOSE** **:** To analyze claims and determine benefits due ensuring compliance with plan provisions; to… more
- TEKsystems (Deerfield Beach, FL)
- …skilled mechanic looking to shift gears in your career? We are seeking Mechanical Claims Analyst to join our expanding customer contact team. In this role, you'll ... expertise and in-depth knowledge of vehicle mechanics to assess and process mechanical claims . This opportunity offers a refreshing change of pace, allowing you to… more
- Rochester Regional Health (Rochester, NY)
- …effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials ... to improve a complex business process. RESPONSIBILITIES: + Review and accurately process claim edits in a system work queue. Accurately handle claim adjustments… more
- Sedgwick (Bartlesville, OK)
- …PURPOSE** **:** Step into a vital role at the heart of the insurance claims process. As a Customer Experience Specialist, you'll be the first point of contact ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… more
- Elevance Health (AL)
- …with claims processing software and SQL/data analysis tools is preferred . + Expertise in Advanced Negotiation & Dispute Resolution, particularly in handling ... Specialist II** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to… more