- El Paso County (Colorado Springs, CO)
- …you'll oversee several high-impact programs, such as unemployment insurance claim processing , administrative leave placements, file preservation notices, ... several high-impact employee relations programs, including unemployment insurance (UI) claims , administrative leave placements, file preservation notices, EEO-4 reporting,… more
- Zurich NA (Schaumburg, IL)
- …+ Knowledge of reinsurance claim recoverable process and its link to direct claim processing . + Comfortable working in team settings. + Ability to interact ... ceded reinsurance transactions and partnering across finance, actuarial, underwriting, claims , and global reinsurance teams. The Reinsurance Financial Associate will… more
- IQVIA (Durham, NC)
- …training, education, or equivalent experience required + Experience in pharmacy operations/ claims processing or equivalent experience required + Experience ... appeal status) + Pharmacy Support (responsible for receiving medical claims from HCPs or patients and vetting the ...claims from HCPs or patients and vetting the claim against program specific business rules to determine if… more
- US Tech Solutions (Columbia, SC)
- …medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. + Monitors process's ... sets or clinical guidelines. + Provides support and review of medical claims and utilization practices.. **Responsibilities:** + May provide any of the following… more
- US Tech Solutions (Columbia, SC)
- …medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. Monitors process's ... protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. **Responsibilities:** + May provide any of the… more
- CVS Health (Sacramento, CA)
- …Can review a clinical determination and understand rationale for decision. Able to research claim processing logic and various systems to verify accuracy of ... claim payment, member eligibility data, billing/payment status, and prior...person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …copay assistance programs. This includes call center services (inbound and outbound) and claims processing operations. They are part of a highly concierge 'white ... for a degree. + Minimum three years leading a claim /customer service or related team in a production or...call center needs with expertise in insurance verification and claims + Ability to effectively evaluate performance, resolve complaints,… more
- Zurich NA (Schaumburg, IL)
- …+ Knowledge of reinsurance claim recoverable process and its link to direct claim processing . + Comfortable working in team settings. + Ability to interact ... ceded reinsurance transactions and partnering across finance, actuarial, underwriting, claims , and global reinsurance teams. The Reinsurance Financial Associate will… more
- Marriott (Anaheim, CA)
- …pre-employment screening, benefit and retirement plan administration, worker's compensation claim management, file management, New Hire Orientation, FMLA/CFRA leave ... * Maintain a high-level of confidentiality and data integrity. * Provide payroll processing support. * Reinforce meal and rest break compliance as well as time… more
- Guidehouse (Birmingham, AL)
- …denials from payers by timely submitting all information needed to complete claims processing . The Central Denials Account Representative conducts thorough ... Files + 835 Electronic Files + UB04's and 1500 Claim Files + Medical Record + Making outbound calls...of concern or areas of improvement. + Resubmit Corrected Claims and supporting documentation as need for the patient… more