- Sedgwick (Tampa, FL)
- …service in medical field preferred. Workers compensation, disability and/or liability claims processing experience preferred. **Skills & Knowledge** + Knowledge ... and triage as necessary. + Enters demographics and UR information into claims or clinical management system; maintains data integrity. + Obtains all necessary… more
- Centene Corporation (Frankfort, KY)
- …best practice and quality standards. + Applies a comprehensive knowledge of claims processing , provider customer service and payment knowledge to escalated ... SalesForce, and Microsoft Access. Knowledge and understanding of managed care claims processing systems and medical claims coding preferred **Licenses and… more
- US Tech Solutions (Columbia, SC)
- …provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, ... collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines… more
- Northwell Health (Lake Success, NY)
- …time off. In this role you will be ensuring timely and accurate claims processing , managing denials, and assisting with billing-related reporting and audits. ... office. Requirements: * 5+ years of experience in medical billing and claims processing , and insurance follow-up. * Certification in medical billing and coding… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- …teams. . Provide subject matter expertise (SME) on payer workflows such as claims processing , member onboarding, provider data management, care management, and ... (https://youtu.be/YSXgCJSXL44) By playing this video you consent to Google/YouTube processing your data and using cookies -Learn more (xweb.asp?clid=21001&page=cookiespolicy#integrationofyoutube)… more
- Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
- …**Data Integration & Management** + Explore and analyze common pharmaceuticals data (eg, claims ) as well as novel data sets based on lab and EHR systems. ... unified view of stakeholder interactions. + Apply natural language processing (NLP) to extract insights from unstructured medical texts,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- HCA Healthcare (Denver, CO)
- …otherwise assigned) . Work with defense legal counsel to coordinate the investigation, processing and defense of claims against the facility; records, collects, ... to defense attorneys any requested information and documents necessary manage facility claims while maintaining privilege of PSWP . Notify and interact with HCI… more
- Highmark Health (Pittsburgh, PA)
- …issues related to supported technology. Manage utilization review, translation of foreign claims , coordination of benefits (COB), and processing of claims ... employees. **GENERAL OVERVIEW** This job oversees, develops, and manages the end-to-end claims functions and operational inputs including but not limited to the… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …datasets from IQVIA, Symphony, Market Access Data (ie patient longitudinal data, claims data, distribution, sales, demand, promotion, formulary). + Strength in one ... tools such as MicroStrategy, PowerBI, etc + Experience in processing , analyzing, and synthesizing various data sources (syndicated, specialty...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Walmart (Pampa, TX)
- …by ensuring proper policies and procedures are followed Ensures the timely processing of claims forexample damaged defective returned liquidated items and ... Manages facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of policiesprocedures… more