- Community Health Systems (Fort Smith, AR)
- …appropriate documentation, if applicable._ + _Ensures compliance procedure for prompt recording/ processing of all refunds._ + _Communicates any refund issues with ... if a payor or patient has overpaid on the account._ + _Prices claims using contracts, pricers, and payment methodologies to validate refund requests from payors._… more
- Insight Global (King Of Prussia, PA)
- …and Requirements - Prior experience working for Healthcare Insurance companies - Healthcare Claims experience ( claims processing , payment and adjudication) - ... customers, as part of the Services Delivery Team, to understand the customers' claim system(s), payment policies, and integration data elements managed using CXT for… more
- OhioHealth (Columbus, OH)
- …obtain all necessary paperwork. 2. Triage incoming calls within the phone processing benchmarks. Answers multi line phone system, screens calls for office/hospital ... to include but not limited to: attachment of requested dictation to claims , addition of diagnosis allowances and authorization numbers 6. Refer utilization… more
- Capital One (Richmond, VA)
- …open and collaborative team environment. The primary functions for this role include processing incoming fraud claims for the Fraud Department, providing decline ... judgment in decision making. **Responsibilities** + Process incoming Fraud Claims received via email, fax and/or mail + Process... received via email, fax and/or mail + Process claim declines as appropriate to other financial institutions +… more
- Trinity Health (Des Moines, IA)
- …copier, printers, etc. Knows location and use of manuals pertaining to claims processing . Accesses necessary information using appropriate resources, ie manuals, ... in a timely manner. Notifies appropriate staff when provider is approved for claims with the Health Plans. Keeps records of all providers, provider numbers and… more
- AO Smith (Milwaukee, WI)
- …employees and retirees on eligibility for health insurance including coverage and claim processing including amount of coverage + Manages Qualified Medical ... and track leave of absence/disability programs to ensure employee claims are processed and paid timely. + Administer benefit...and educate HR to work through benefit issues and claims questions + Assist with ACA compliance + Ensure… more
- Actalent (Cary, NC)
- …receive the best possible care by effectively managing insurance communications, processing pharmacy claims , and assisting with various projects. ... company cannot serve the patient. + Appropriately process pharmacy claims in MIS. + Recognize and understand pharmacy ...claims in MIS. + Recognize and understand pharmacy claim responses. + Manage inbound calls from patients, clients,… more
- Robert Half Accountemps (Fishers, IN)
- …* Administer claims and resolve disputes to ensure smooth payment processing . * Execute billing functions with precision and attention to detail. * Follow ... * Handle inbound calls and inquiries related to billing and claims administration. * Coordinate commercial collections, maintaining professionalism and efficiency.… more
- Stony Brook University (St. James, NY)
- …systems expertise, patient registration and throughput, health information management, claims processing and reimbursement, payer contracts, and applicable ... knowledge of integrating third-party systems, including insurance eligibility verification, claim scrubbing, electronic claims submission and remittance, encoder… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …refund requests + Complex account reconciliation + Account adjustments, bad debt processing + Third party, Medicare, Managed Care, and private billing, claim ... + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems (improper patient...and private pay + Month-end closing process + Re-bill claims to improve reimbursement from NETRX reporting + Assist… more