- 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
- CVS Health (Harrisburg, PA)
- …for the review of refund checks from providers and/or members to determine if a claim is overpaid. If the claim is overpaid, choose detailed reason for ... scheduled during core business hours. **Required Qualifications** 2 years HRP claims processing or customer service experience -SCM system -ASD -OPT-not required,… more
- Emerson (Shakopee, MN)
- …**In This Role, Your Responsibilities Will Be:** + **Workers' Compensation & Claims Management** : Leading the workers' compensation process, including claim ... return-to-work planning. Partnering with legal and insurance teams to manage claim -related litigation, prepare documentation, and provide testimony as needed. +… more
- Kennedy Krieger Institute (Baltimore, MD)
- …balances on the utilizing Patient Accounting software. 5. Timely submission/transmission of claims and verification of claim acceptance where appropriate for ... accounts. Patient Accounts Representatives may also be responsible for claim submission depending on their assigned accounts. **Responsibilities** 1. Responsible… more
- Hartford HealthCare (Farmington, CT)
- …Receivable & Denial Specialist II assures timely and accurate submission of claims on UB04 or HCFA1500 (bills), monitor responses from clearinghouse, review ... or overpayments via payer portal, payer chat or payer customer service, analyze claim adjustment reason codes, analyze remittance advice remark codes and any revenue… more
- Sedgwick (Southfield, MI)
- …of financial experience or equivalent combination of education and experience required. Claims management experience preferred . **Skills & Knowledge** + Good ... agencies as applicable. + Notifies employees verbally and in writing of claim overpayments. + Responsible for manual calculations of employee benefit overpayments.… more
- Elevance Health (Mendota Heights, MN)
- …The **Excess Loss Specialist** is responsible for working independently reviewing claims and interpreting contracts. Works with complex concepts of excess loss, ... + Assists auditors with obtaining information for stop loss claims . + Tracks payments from third-party administrators that have...as the liaison with auditors when clients hit a claim . **Minimum Requirements :** + Requires a HS diploma… more
- Actalent (Redlands, CA)
- …team goals. Qualifications: + Basic understanding of provider data and healthcare claims processes. + Familiarity with EZCap (experience preferred ). + Ability ... Job Title: Provider Data Analyst - Credentialing & Claims Support Position Overview: We are seeking a...This role involves converting and interpreting provider data, assessing claim routing, and ensuring accurate provider profiles within our… more
- Lowe's (Suwanee, GA)
- …+ Escalated customer concern resolution + Working alerts and queues + Inputting customer claims into the claim portal system + Responsible to support delivery ... with the third-party logistics partner to address and resolve claims (customer and cargo), updates Lowe's claims ...or equivalent + 1 year of directly related experience ** Preferred Qualifications** + 1 year of experience with inventory… more
- CareFirst (Baltimore, MD)
- …member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. ... provider and broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as… more