- 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
- 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 (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
- 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
- Sedgwick (Irving, TX)
- …questions and issues in accordance with designed guidelines and policies. + Communicates claims status and current claim activity with client and appropriate ... medical contact; responds to inquiries about jurisdiction- and claim -specific issues. + Enters data into claims system(s) and ensures claim files are… 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
- Beth Israel Lahey Health (Charlestown, MA)
- …Billing System. . Works assigned accounts with the highest level of complexity within claim edit work queue(s) daily and resubmit claims through the Epic billing ... . Works assigned accounts with the highest level of complexity containing External claim edits from Clearinghouse and resubmits claims through the Epic billing… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …characteristics of The BAYADA Way: compassion, excellence and reliability. + Degree preferred (combination of education and experience may be used in lieu of ... payor organizations, external business or clients ensuring timely payment. + Complete claim denial management functions to ensure timely follow-up with denied … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …needed for accurate reporting of the service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing system and ... ensuring it is correctly reflected on submission of the claim . They register new patients in the system, including...is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to… more