- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …and automation into core business functions, such as underwriting, pricing, and claims processing , while staying ahead of industry trends, regulatory changes, ... fraud detection, and customer segmentation strategies + Claims Analysis: Analyze claims data to identify patterns, improve processing efficiency, and detect… more
- General Motors (Warren, MI)
- …to achieve or surpass all defined quality and claims -related KPIs-including carrier claims recovery rates, claims processing cycle times, and compliance ... to ensure the team executes against operational quality, material returns, and carrier claims KPIs for all North America shipments. You will manage and direct daily… more
- Stanford Health Care (Palo Alto, CA)
- …The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts ... - Payer clerical and technical denial review and request processing including basic appeals - Payment posting and batch...payer by phone or via the portal + Resolving claim edits + Reviewing payer variances and pursuing underpayments… more
- CGI Technologies and Solutions, Inc. (Indianapolis, IN)
- …By playing this video you consent to Google/YouTube processing your data and using cookies -Learn more (xweb.asp?clid=21001&page=cookiespolicy#integrationofyoutube) ... * Leverage tools like Kafka, AWS Kinesis, or Pub/Sub for real-time processing across policyholder journeys. * Implement automated data cataloging, lineage tracking,… more
- Colorado State University (Fort Collins, CO)
- …of pharmacy operations + Strong customer service skills + Expert in processing insurance claims , handling rejections, and prior authorizations Knowledge, Skills, ... when designated by position in pharmacy workflow + Navigates insurance requirements, claim submission, and troubleshooting rejected claims + Handles prescription… more
- TEKsystems (Rochester, NY)
- Description SBO-Single Business Office - Corrects Error or Edits needed to get claim out - Incorrect, patient id, Diagnosis code isn't accepted, payer etc. - Will be ... back office and verification work. -Will be using Excel heavily and will be processing new information through patient accounts. - If any information is missing they… more
- The Cigna Group (Morris Plains, NJ)
- …NCPDP guidelines; Point of Sale; Coordination of Benefit ("COB"); manual submitted claims processing ; retail pharmacy network system; CA-7 Scheduler; Endeavor; ... with or knowledge of: IBM Mainframes; COBOL6; JCL; VSAM; DB2; MQ; TSO/ISPF; PBM claim adjudication processing ; Inflation Reduction Act ("IRA"); CMS (HIPPA);… more
- St. Luke's Health System (Boise, ID)
- …and third-party issues such as prior authorization, step therapy, reviewing denied claims , and processing overrides. Works with an interdisciplinary team of ... copay card programs. + Accurately calculate costs and savings while processing specialty medications. + Provide customer service and explain complex insurance… more
- Ohio Machinery Co (Broadview Heights, OH)
- …to supervise the Truck Group Warranty Analysts, providing leadership and support for the processing of warranty claims specific to repair orders within the Truck ... will oversee the entire Truck Group warranty process, including submitting claims , organizing receipts, communicating variances, and resolving variances to the… more
- Commonwealth of Pennsylvania (PA)
- …questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are ... to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved...Select the Level of Performance that best describes your claim . + A. I have professional experience related to… more