- Love's Travel Stops & Country Stores (Oklahoma City, OK)
- …claimant if appropriate. + Develop a plan of action to monitor and accurately document claim details. + File new claims with proper carrier or state agency. ... plan of action to satisfactorily and efficiently resolve each claim . **Job Functions:** + Communicate consistently with all relevant...preferred + 1 year experience working as a claims adjuster, working in insurance claims , customer… more
- Great River Health (Mount Pleasant, IA)
- …and assists in the reimbursement for services provided. Accurately files insurance claims for the purpose of settling claims with insurance carriers. ... errors. Handles electronic billing functions which includes electronically filing claims and maintaining the electronic filing system. Prepares itemized statements,… more
- Trinity Health (Davenport, IA)
- …of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates ... objective of maximizing reimbursement for services rendered and ensuring claims are paid or settled in a timely and...or settled in a timely and accurate manner. Researches claim rejections, make corrections, take corrective actions, and/or refer… more
- Amentum (Washington, DC)
- …a Lead Project Manager, performing the following duties: + Oversee all aspects of Claim Review and Intake team management. + Lead efforts to recruit, retain, and ... and graphs. + Oversee the coordination of Project Supervisors to direct the Claims Review and Intake teams. + Create, format, and refine Standard Operating… more
- CDM Smith (Raleigh, NC)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more
- CVS Health (Columbus, OH)
- …in Microsoft Office Suite applications including Excel, Word, and Outlook ** Preferred Qualifications** + Clinical Claim Review background + ... Aetna's standard contracts and provider contracting methodologies + Working knowledge of claim systems preferred + Understanding of clinical editing concepts… more
- Sedgwick (Las Vegas, NV)
- …+ Responsible for managing defense counsel in litigation of serious and complex claim , litigated claims as well as complex coverage scenarios; manages defense ... of education and experience required. Experience with commercial lines claims and litigation in multiple states preferred ....lines claims and litigation in multiple states preferred . **Skills & Knowledge** + Exposure to and knowledge… more
- Zelis (St. Petersburg, FL)
- …+ 3 - 5 years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred + Solid understanding of audit techniques, identification of revenue ... concepts to expand the DRG product. + Manage assigned claims and claim report, adhering to client...What you'll bring to Zelis: + Registered Nurse licensure preferred + Inpatient Coding Certification required (ie, CCS, CIC,… more
- Actalent (West Des Moines, IA)
- …for pending claims , auditing and pricing a wide variety of claim types, and ensuring compliance with departmental and company policies. Responsibilities + ... procedures. + Audit and price a wide variety of claim types. + Identify claims with inaccurate...independently. Additional Skills & Qualifications + Medical Coding licensure preferred ; open to candidates actively pursuing certification such as… more
- Guthrie (Sayre, PA)
- Position Summary: Responsible for non‐complex electronic and paper claim submissions to insurance payers. Coordinates required information for filing secondary and ... tertiary claims reviews and analyzes claims for accuracy,...certification in medical billing and coding or Associates degree preferred . Experience: Strong organizational and customer service skills a… more