- Travelers Insurance Company (Melville, NY)
- …equipment breakdown, and overall insurability. Investigate less complex Equipment Breakdown claims as requested by the claim department. Evaluate elements ... recommending corrective actions. Work cooperatively with Boiler and Machinery underwriting and claim groups, in support of helping them make informed decisions to… more
- US Tech Solutions (Columbia, SC)
- …medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. Monitors process's ... protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. **Responsibilities:** + 80% May provide any of the… more
- BrightSpring Health Services (Valdosta, GA)
- …remits for denial reasons and experience with State Billing Portal sites, preferred .* Experience in filing claim appeals with insurance companies to ... accounts list, code and comment prior to monthly Critical Account call.* Rebill claims for any outstanding AR that is collectible. Provide detail comment in aging… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …player. + Proficient in computer systems with high technical aptitude. + Advanced claims processing expertise preferred but can be trained + Strong understanding ... assigned. + Utilize self-help tools to generate approved member claim history reports. + Stay current and adapt to...of the healthcare industry and claims processing ( preferred ). About At Brighton Health… more
- CVS Health (Olympia, WA)
- …to assist customers in understanding components of the Aetna products including claims , accumulators, usage and balances, and cost sharing. + Answers questions and ... while avoiding over-committing. + Other activities may include providing claim status information, benefit coverage interpretations, and explaining plan eligibility.… more
- Community Health Systems (Franklin, TN)
- …for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government ... Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred + 0-2 years of experience in medical collections, accounts receivable,… more
- AdventHealth (Altamonte Springs, FL)
- …to appropriately reconcile patient accounts. Resolves and resubmits rejected claims appropriately as necessary. Processes daily and special reports, unlisted ... invoices and letters, error logs, stalled reports, and aging claim reports. Reviews previous account documentation, determining appropriate action(s) necessary to… more
- CVS Health (Hartford, CT)
- …work environment that encourages continuous professional growth. As part of the AT Claim Organization, you will be responsible for managing a team of software ... developers supporting our Claim applications. The Claim Organization is accountable...growth mindset (agility and developing yourself and others) skills ** Preferred Qualifications** + Software Engineering Master Certification (SEMC) +… 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
- St. Luke's University Health Network (Allentown, PA)
- …for entirety of the SLETS Revenue cycle including submission of ambulance billing claims , follow-up on claim denials, posting payments to customer accounts, ... review of past due accounts for collections submission. + Review billing claim overpayments and process refunds. + Handle insurance payment negotiations based on… more