- Molina Healthcare (Fort Worth, TX)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments...years operational managed care experience (call center, appeals or claims environment). + Health claims processing… more
- Molina Healthcare (Omaha, NE)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates...**Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims … more
- UTMB Health (Galveston, TX)
- …Specialist will be responsible for billing all third party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital ... claims . Identifies billing issues affecting hospital and/or physicians ...and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues… more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians ...and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues… more
- Centene Corporation (Tallahassee, FL)
- …Complies with all policies and standards **Education/Experience:** Associate's degree and claims processing , billing and/or coding experience preferred. Three ... updates to key provider groups and model contract + Research and identify any processing inaccuracies in claim payments and route to the appropriate site… more
- Commonwealth of Pennsylvania (PA)
- …describes your claim . + A. I have experience utilizing word processing and spreadsheet software to prepare records and reports, utilizing scheduling software, ... 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
- Molina Healthcare (Carson City, NV)
- …and test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Hartford HealthCare (Farmington, CT)
- …they pertain to billing processes and procedures . Knowledge of insurance claim processing and third-party reimbursement . Knowledge and detailed understanding ... efforts to review and resolve issues related to insurance claim denials, no response claims and payment...related to insurance claim denials, no response claims and payment variances including underpayments and overpayments. Averages… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance ... operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors.… more
- Cardinal Health (Doral, FL)
- …GED or equivalent work experience, preferred + Strong knowledge of insurance claim processing and denial management preferred. + Familiarity with Medicare, ... Collector is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances… more