- AmeriHealth Caritas (Charleston, SC)
- …education and experience preferred. + Required ability to focus on technical claims processing and Provider data maintenance knowledge. + Required understanding ... medical policy and edit reviews. + Requests/runs queries to identify root causes of claim denials, incorrect payments and claims that are not correctly submitted… more
- AmeriHealth Caritas (Charleston, SC)
- …**required** + **Requires:** + Experience in State-specific Medicaid rules + Claims processing , healthcare billing and Provider data maintenance knowledge ... this position will work in conjunction with the Enterprise Claims Department to ensure all contractual claim ...Enterprise Claims Department to ensure all contractual claim requirements are met with quality and consistency. **Work… more
- Henry Ford Health System (Detroit, MI)
- …and external revenue cycle systems to manage receivables. + Expert knowledge in all claims processing , including claims submissions , denials, and follow up ... claim forms (ie UB04 or 1500) through the claims editing software. Understands the claim editing process and resolving the edits based on appropriate… more
- Commonwealth of Pennsylvania (PA)
- …process of Individual Support Plan development in HCSIS; assisting providers with claims resolution or billing issues; and participating in the Office of ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....to provide complete and accurate information may delay the processing of your application, or result in a lower-than-deserved… more
- Trinity Health (Davenport, IA)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting or ... of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …correct payer. Work all pre-billing/post-billing reports to ensure correct data on claims . Identify and resolve claim issues. Guarantee timely secondary billing ... to billing/collections (timely filing, specific invoicing requirements, etc.) Ensure timely processing of any re-billing invoices/ claims . Manage any fiscal… more
- Robert Half Legal (New York, NY)
- …seeking a Claims Technical Specialist to oversee the examination, evaluation, and processing of complex claims estimates and paid claims values, ensuring ... policy terms and conditions in alignment with the client's Claims Philosophy. This role supports the claims ...with laws, regulations, and best practices. + Deliver superior claim outcomes through exceptional customer care and responsiveness. +… more
- City and County of San Francisco (San Francisco, CA)
- …direction, the Worker's Compensation Supervisor assists and provides first-line oversight of claims adjusting and processing teams for the Workers' Compensation ... issues related to medical clinic operations. 14. Provides ongoing system support to claims staff. 15. Accurately estimates the potential claim costs (reserves)… more
- Sedgwick (Irving, TX)
- …Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims . **ARE YOU AN IDEAL CANDIDATE?** We are looking ... naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes… more
- Sedgwick (Eden Prairie, MN)
- …federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Informs ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...Makes claim determinations to approve non-complex ADA claims or makes a recommendation to team lead to… more