- Highmark Health (Augusta, ME)
- …(ASO); TPA services with an expanded BCI/HNAS offering and management of claims funding and cash management. While identifying and driving process improvements ... in projects and activities that impact the Sales and Operations and claims finance business unit functions. HNAS (Health Now Administrative Services) offers… more
- CareFirst (Baltimore, MD)
- …physicians and/or ancillary providers as well as knowledge about contracting and claims processing . + Experience in revenue cycle management and value-based ... use of CPT, HCPCS, and ICD 10 codes in claims submissions. Utilizes coding expertise, combined with medical policy,...to maximize quality payments and risk adjustment. Translates from claim language to services in an episode or capitated… more
- Molina Healthcare (GA)
- …+ Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission. ... including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure… more
- Fair Haven Community Health Care (New Haven, CT)
- …Fair Haven prides itself on efficient billing services including the filing of claims , appeals processing , authorizations, and, above all, a great passion for ... companies either electronically or by paper when necessary + Work claims and claim denials to ensure maximum reimbursement for services provided Carrier… more
- Sedgwick (Atlanta, GA)
- …college or university preferred. **Experience** Four (4) years of experience in claims processing or related business experience, or equivalent combination of ... **Skills & Knowledge** + Working knowledge of billing and reconciliation systems, claim systems, financial services, and insurance products + Excellent oral and… more
- Highmark Health (Pittsburgh, PA)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Analyze and evaluate claim processes specific to professional, hospital, ambulatory surgical center,… more
- EMCOR Group (Manchaca, TX)
- …accordance with applicable established policies and procedures. + Manage all data processing operations to ensure timely and accurate reporting as required. + Ensure ... with Purchasing Manager for inclusion of terms and discounts. + Coordinate claims issues and legal activity with EMCOR Construction Services legal counsel by… more
- Alabama Oncology (Birmingham, AL)
- …for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, ... explanations of benefits and exercises all options to obtain claim payments. + Reviews credit balance reports for correct...manner. + Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends… more
- Bozeman Health (Bozeman, MT)
- …The supervisor supports staff in maintaining accuracy and timeliness in claims processing to maximize reimbursement. Additional responsibilities include ... Three (3) years of experience in medical billing and claims . + One (1) year of supervisory experience. +...monitoring Epic work queues to ensure timely and accurate claim follow-up and resolution. + Develops and leads the… more
- Peachtree Orthopedics (Atlanta, GA)
- …+ Responsible for a variety of medical office /clerical tasks relating to claims processing ; contact patients and responsible parties to resolve past-due ... with minimal or no assistance necessary. + Independently assess claims edits and other billing messages to resolve any...use of modifiers preferred. + Familiar with CMS 1500/UB04 claim form completion, knowledge of Medicare, Managed care and… more