- NTT DATA North America (Plano, TX)
- …methodology/ fee schedule/ Required Skills for this role include: + 2 years of healthcare claims processing (full cycle: Pay, Pend, Deny) + 2 years using a ... this Role the candidate will be responsible for: + Processing of Professional and Hospital claim forms...+ High school diploma or GED. Preference + Experience processing claims in Amisys or Xcelys is… more
- LA Care Health Plan (Los Angeles, CA)
- …all aspects of planning, execution, reporting and corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. This ... and vendors. Provides timely and accurate deliverables to ensure claims processing are in compliance with regulatory...liaison for Centers for Medicare and Medicaid Services (CMS) claim audit section of LA Care delegates. Reviews and… more
- UCLA Health (Los Angeles, CA)
- …be responsible for monthly random and focus audits of all claim processing activities to identify inaccurate claims adjudication. This will involve reviewing ... UB04 and CMS 1500 healthcare claims and adjustments for accuracy, and appropriate application ...resolutions, adjustments, appeals, and reopen guidelines * Understanding of Claim Adjustment Reasons and Remittance Advice Remark codes *… more
- GuideOne Insurance (Denver, CO)
- … Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without ... and cause of loss on routine to more complicated claims , which includes but is not limited to policy...coverage and reservation of rights letters. + Maintains effective claim file documentation and diary system. Monitor diary to… more
- Pike Corporation (Mount Airy, NC)
- …internal knowledge base. + Handles multiple functions related to business operations, claims processing , and office workflows. + Recognizes and resolves basic, ... Position Overview: The primary purposed of Claims Specialist is to manage various claims...vehicles and equipment + Utility companies + Handles routine claim status inquiries from any partners in a courteous… more
- JB Hunt Transport (Lowell, AR)
- …is responsible for the management of the company's risk mitigation programs, including claims processing , as well as the structure, design, and procurement of ... **Job Title:** Vice President Insurance, Risk Management, and Claims **Department:** Insurance **Country:** United States of America **State/Province:** Arkansas… more
- Providence (CA)
- … issues. + 7 years of relevant general and professional liability claims processing or management experience **Preferred qualifications for this position ... **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many...for each matter:** + Develop and document for each claim or lawsuit a plan of action for resolution… more
- Commonwealth Care Alliance (Boston, MA)
- …certifications **Required Experience (must have):** + 3+ years in healthcare claims processing , provider reimbursement, or payment integrity. + Experience ... 011250 CCA- Claims **_This position is available to remote employees...**Essential Duties & Responsibilities:** + Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms, state… more
- CHS (Clearwater, FL)
- … claims prior to payment. * Oversight for the ongoing management of claims processing technology, including plan building and identification of new and ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...total per household per month (PHPM) and per inbound claim cost so that improvements in productivity and efficiency… more
- Marshfield Clinic (Marshfield, WI)
- …The Claims Auditor has working knowledge of the overall aspects of claim processing , both in and outside of Security Health Plan. Audit responsibilities ... the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:**...**Minimum Required:** Three years' experience related to health insurance claim processing . Three years' experience related to… more
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