- EFI Global (Los Angeles, CA)
- …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 reported back to the requesting party in adherence to best practices.… more
- Elevance Health (Greeneville, TN)
- …background. + Travels to worksite and other locations as necessary. ** Preferred Skills, Capabilities, and Experiences:** + Claims Resolution experience ... action plan implementation and monitoring education, contract questions and non-routine claim issues. + Coordinates communications process on such issues as… more
- Community Health Systems (Franklin, TN)
- …of documentation and identifying areas for provider education. + Works coding-related claim edits, holds, and scrubs in the electronic billing system (eg, Athena ... Collector), ensuring timely claim resolution and reimbursement. + Collaborates with physicians, revenue...Health Information Management, Healthcare Administration, or a related field preferred + 2-4 years of experience in physician coding,… more
- Hartford HealthCare (Farmington, CT)
- …Coding experience is required for this position.* *CHONC certification preferred * *_Position Responsibilities:_* *Key Areas of Responsibility* *Coding* 1. Applies ... by the American Health Information Management Association *Issue Resolution* 1. Review claim edits and revise coding/charging as appropriate for specific range of… more
- Intermountain Health (Phoenix, AZ)
- …queues and communicate issues and trends to leadership. Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT ... group, and individual government enrollments for technical and professional fee claim reimbursement. 2. Coordinates all aspects of provider enrollment with… more
- UNUM (Denver, CO)
- …+ Develops high level actions through risk and H&P analysis and claim consultation + Utilizes expertise in Unum services and solutions (implementation, contracts, ... planning and prepares for pre-renewal face to face visit to review claim trend analysis and Integrated Disability Management models to discuss any issues… more
- Trinity Health (Fort Lauderdale, FL)
- …educate on improved documentation to support coding. Neurosurgery experience is highly preferred . CPC license is REQUIRED. **What you will do:** Responsible for ... a. Perform coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review b. Responsible for proofing daily charges for accuracy… more
- St. Luke's University Health Network (East Stroudsburg, PA)
- …capture for physician practices. This includes managing Charge Review and Claim Edit Practice work queues, patient registration, coding diagnoses, insurance ... verification, and charge entry to maximize reimbursement as a clean paid claim . JOB DUTIES AND RESPONSIBILITIES: + Utilize fundamental billing and coding knowledge… more
- CVS Health (Bloomington, IL)
- …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… more
- Elevance Health (Topeka, KS)
- … Qualifications:** + Travel to worksite and other locations as necessary + Claims experience is strongly preferred + Kansas Medicaid regulatory knowledge ... corrective action plan implementation and monitoring education and non-routine claim issues + May coordinate Provider Manual updates/maintenance + Identifies… more