- Sedgwick (Phoenix, AZ)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- University of Washington (Seattle, WA)
- …information needed to clear the charge edit as appropriate. + Resolve all pre- processing claim edits that indicate errors needing correction. This may involve ... (Patient Account Representative 2).** This position is responsible for claims review, clearing claim edits, and timely and accurate submission of claims… more
- Raphael and Associates (Rutherford, NJ)
- …the claims management system. You will play a key role in preparing claims for further processing by entering data, verifying policy details, and assigning ... adjuster and supervisor. + Set adjuster diaries with new claim notifications and necessary actions. + Claims ...new claim notifications and necessary actions. + Claims Acknowledgement Letters: + Generate and send acknowledgement letters… more
- Cedars-Sinai (Los Angeles, CA)
- …arise. **Department specific responsibilities include:** Analyzes, trends, reports out, and resolves pended claims in PB Claim Edit WQs and PB Payer Rejection ... clean claim submissions and timely reimbursement. Completes special PB claims related projects as assigned. These projects could include trending issues to… more
- WTW (Miami, FL)
- …such as supporting the effective management, analysis, and resolution of claims , ensuring accurate processing and timely communication between clients, ... Administration & Reporting** + Receive, register, and review incoming claim notifications. + Prepare claim summaries, bordereaux,...timely entry of claims data into the claims management system. **Analysis & Processing ** +… more
- CVS Health (Franklin, TN)
- …missing or insufficient information. The position is critical to maintaining timely and compliant claim processing . + Route claims to the correct team or ... calls to members, or other stakeholders to obtain missing claim details. + Review and analyze claims ...with excellent organizational and problem-solving skills. + Proficiency in claims processing systems and Microsoft Office Suite.… more
- Robert Half Accountemps (Des Moines, IA)
- … submissions and take corrective actions. * Provide regular updates and reports on claim processing activities. Requirements * At least 1 year of experience in ... In this role, you will handle medical-only workers' compensation claims , ensuring accuracy and prompt processing . This...issues. * Support hospital billing processes and ensure proper claim handling. * Maintain detailed records for claims… more
- Cedars-Sinai (CA)
- …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... Dispute Request (PDR) fulfillment process from the point of claim review through letter processing and records...required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred.… more
- Osmose Utilities Services (Atlanta, GA)
- …+ Coordinate the intake, reporting, and follow-up of work-related injury and illness claims . + Assess the classification of each claim (first aid, medical ... Summary of position: The Claims Analyst will play a key role in...supervisors, third-party administrators (TPAs), and insurance carriers. + Monitor claim status and ensure timely and accurate claim… more
- Stanford Health Care (Palo Alto, CA)
- …procedures and the applicable service agreement. Review reserves, settlement activity, and claims costs. Participate in periodic claim reviews and provide ... **A Brief Overview** Under the direction of the Director, Claims & Litigation Strategy, the Claims Manager...to support loss prevention. + Ensure timely and accurate processing of all claim invoices. **Education Qualifications**… more