- Elevance Health (Norfolk, VA)
- …using medical charts, medical notes, and provider contracts. + Verifies dollar amount on claim is correct in claims system and writes report of the findings ... charts, medical notes, itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider reimbursement policies, and… more
- HCA Healthcare (Nashville, TN)
- …Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, ... and HCA's legal team to assess the validity of claims and assist in the pursuit of payment on...education and guidance to help prevent recurrence of similar claim issues. **Major Responsibilities:** + Conducts comprehensive clinical record… more
- Molina Healthcare (GA)
- …and conversion of new and existing health plans. + GA Medicaid claims / reimbursement/ coding experience is highly preferred **JOB QUALIFICATIONS** **Required ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Ankura (Phoenix, AZ)
- …in research and analysis project cost records and financial statements + Reconcile claim amounts to accounting systems and to insurers' calculations + Use Ankura's ... proprietary tools and industry standards in the development of claim methodology and work product + Develop computer models of schedules, contractor production rates… more
- Southeast Health (Dothan, AL)
- …Performs daily activities involved in the reimbursement process, ie, claims filing/follow-up, entry of payments/adjustments, follow-up on non-payment or payments ... School diploma; + One year of revenue cycle experience preferred ; + Working knowledge of CPT and ICD 10...working knowledge of regulatory guidelines for billing; + Provides claim submission for services provided at SEH; + Provides… more
- Cardinal Health (Salt Lake City, UT)
- …team to ensure timely and accurate resolution of outstanding insurance claims . This role leads strategy development, performance monitoring, and process improvement ... rates, and collection targets. + Develop and implement processes to improve claim resolution timelines and reduce denials and underpayments. + Provide training,… more
- Banner Health (AR)
- …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing ... of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation… more
- CVS Health (Phoenix, AZ)
- …of CVS Caremark's extensive Pharmacy Audit division. The Medicare Pharmacy Claims Auditor will administer assigned Medicare Part-D Compliance Audit Programs, review ... pharmacy submitted Medicare claims , make independent decisions, and call network pharmacies to...may include: -Telephone outreaches to network pharmacies to verify claim information. -Transmission of audit requests to pharmacies. -Review… more
- Covenant Health (Lubbock, TX)
- …of claim billed and collected on behalf of Covenant. This individual addresses claim edits, files all claims on either a UB-04 (RHC) or 1500 (835/837 ... must empower them. **Required qualifications:** + Experience in computer applications. ** Preferred qualifications:** + 1 year Health care business office experience… more
- LG Energy Solution (Holland, MI)
- …also manages the classification and accounting of tolling, rework, and claim costs, while collaborating with cross-functional teams to analyze cost variances ... schedules and resolve closing issues with external vendors, including claim reconciliation and root cause follow-up. Responsibilities: + Ensured production… more