- CVS Health (Bassett, VA)
- …including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. ... cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and… more
- AmeriHealth Caritas (Manchester, NH)
- …processes, ensuring compliance with pricing guidelines, contract standards, and claim payment methodologies. + Drive implementation of electronic strategies to ... improve claims submission, auto-adjudication, and operational efficiency. + Ensure departmental...administration or healthcare management, and equivalent business experience is preferred . + A minimum of 3 years of experience… more
- Independent Health (Buffalo, NY)
- …of the audit plan **.** **Qualifications** + Associates degree required. Bachelor's degree preferred . An additional two (2) years of experience will be considered in ... NYS licensed RN or LPN required. LPN or RN preferred . + Four (4) years of experience working in...Ability to ensure that clinical information translates correctly into claim coding compliance with requested data set. Ability to… more
- EFI Global (Jackson, MS)
- …buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims . + Ensures that assigned cases are investigated and...Licensing** Bachelor's degree from an accredited college or university preferred . IAAI Certified Fire Investigator (IAAI-CFI) certification or Certified… more
- Mount Sinai Health System (New York, NY)
- …required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred . **Responsibilities** 1. Follows up on submitted claims ... **Job Description** Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and… more
- Intermountain Health (Broomfield, CO)
- …Essential Functions* Oversees the day-to-day revenue cycle functions including claims processing, denials, payments,customer service, and follow up on accounts. ... incorrect or outstanding claimsand/or patient issues. Investigates and resolves claims submission, disputes or complaints to resolution,as needed. Resolves… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... the following, but are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up on rejected or denied… more
- MyFlorida (Largo, FL)
- …to, a Level II background check. + Supervisory skills and experience. PREFERRED QUALIFICATIONS Preference will be given to candidates with the following ... responsible for the timely billing and collection of all claims resulting from the delivery of long-term care services...and Commercial Insurance. Ensures timely and accurate submission of claims and conducts a minimum monthly detailed review of… more
- Kemper (Miami, FL)
- …experience required + Claims related computer systems experience required, Guidewire experience preferred + Bilingual in Spanish is a plus _Kemper is proud to be ... our promises._ **Position Summary:** Kemper has an immediate opening for a Casualty Claims Adjuster. In this position, you will be responsible for building rapport… more
- Adecco US, Inc. (Fountain Valley, CA)
- …monitoring and resolution of company car accidents, usage and claims . **Responsibilities** **1. Company Car Accidents** - Investigate, prepare documentation ... monitor and resolve company car usage issues, damages, accidents and claims , working with drivers, Vehicle Administration, regional offices, affiliates and insurance… more