- Cognizant (Blaine, MN)
- …hybrid model focusing on developing and optimizing OnBase applications to enhance our claims processing systems. This role requires a deep understanding of ... will:** + Lead the development and optimization of OnBase applications to improve claims processing efficiency. + Oversee the integration of OnBase Application… more
- 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
- CVS Health (WV)
- …or Certificate of Coverage (COCs) + Experience in research and analysis of claim processing a plus. **Education** High School Diploma or Equivalent **Anticipated ... + 1 year experience that includes both HMO and Traditional claim platforms, products, and benefits, patient management, product, compliance and regulatory… more
- BrightSpring Health Services (Knoxville, TN)
- …+ Stay current with Medicaid claim regulations and ensure compliance in processing . + Track unpaid or delayed claims ; generate reports for management. + ... Provide excellent customer service in line with company values and policies. + Assist with medication preparation and dispensing under Pharmacist supervision. + Support additional pharmacy tasks and operations as directed by management. Qualifications… more
- Health Care Service Corporation (Chicago, IL)
- …+ Certified Professional Coder + Certified Fraud Examiner + Knowledge of health care claims processing and benefit administration. Please note that this role is ... tools and techniques to conduct detailed investigations of potentially fraudulent claim activity by members, employees and providers, both internally and externally… more
- CommonSpirit Health (Prescott, AZ)
- … to insurance companies. Conducts timely follow up with insurance companies regarding claim processing and payment status. + Assists patients in establishing ... + Assists patients via telephone and/or written response regarding account/ claim status inquiries. Responds professionally and within appropriate timeframes to… more
- TEKsystems (Rockford, IL)
- …You'll Do: As a Client Coordinator, you'll be the backbone of our case processing operations. You'll work within CMS portals to manage and track cases, ensuring all ... with internal reviewers who assess treatment and diagnosis details to support insurance claim decisions. Why This Role Matters: You'll be part of the Independent… more
- Philadelphia Insurance Companies (Pasadena, CA)
- …staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. We work ... are assigned. This level of underwriter will be is proficient in processing New Business, Renewals, Endorsements, Cancellations and any other standard Underwriter… more
- Avera (Sioux Falls, SD)
- …to customer's accounts. Additional responsibilities include verifying and correcting billing input for claim processing and reconciles Point of Sale cash flow. A ... Verifies, submits and adjudicates patient billing information, submits necessary claim forms and reconciles accounts receivable remittances appropriately and… more
- Baylor Scott & White Health (Austin, TX)
- …appropriate statistical trend analysis. + Performs root cause analysis of claims /encounters processing and submission issues; develops recommendations based on ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more