- AmeriHealth Caritas (Philadelphia, PA)
- …Research and analyze case documentation, including benefit coverage, prior authorizations, claims , and regulatory guidance. + Communicate with members, providers, or ... representative to clarify appeal intent and gather missing documentation...and Resolution_** + Collaborate with internal departments such as Claims , Medical Management, Legal, and Compliance to obtain necessary… more
- Spectrum Billing Solutions (Skokie, IL)
- …| Billing and Reimbursement Specialist | Billing Specialist |Billing Coordinator | Claims Specialist | Billing Representative | Collections Specialist | ABA ... update and track provider information in the internal credentialing system to ensure that credentials are completed timely and...Billing Specialist | ABA Claims Specialist | Behavioral Health Billing Specialist #RCMAnalyst |… more
- Banner Health (AZ)
- …the best place to work and receive care. The **PFS Insurance Follow-Up Representative (Ambulatory Denials)** is responsible for following up with assigned payer for ... activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …synthesizes data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals. Their work goes beyond extraction; it ... as Network and Pharmacy, ensuring data is pulled using the most representative methods. They also support high-risk regulatory reporting, where precision and speed… more
- Magellan Health Services (San Diego, CA)
- …program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System ... and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS). + Performs as a Verifying Official (VO) on DEERS/RAPIDS… more
- University of Washington (Seattle, WA)
- …Program Manager, the Construction Manager (Healthcare) serves as the University's representative in managing the construction and closeout phase of healthcare ... renovations of portions of an existing building or utility system . The Project Delivery Group places a strong emphasis... for dispute resolution; review and respond to delay claims ; develop proposed solutions to solve outstanding problems. +… more
- Humana (Indianapolis, IN)
- …Horizons in Indiana is seeking a LTSS Provider Education & Outreach Representative (Provider Engagement Professional 2) who is responsible for the day-to-day front ... and resolving issues or complaints. The Provider Education & Outreach Representative will specialize in supporting Long-Term Services and Supports (LTSS) and… more
- Stantec (Charleston, SC)
- …forward. From hospitals and airports to university campuses, mass transit systems , water treatment facilities, mines, and wind farms, we've successfully managed ... is seeking an individual to act as an Owner's Representative , Project Manager for the design and construction of...Evaluate, advise on and assist in resolving disputes and claims - Traditionally reports to project executive or principal.… more
- Sysco (Front Royal, VA)
- …are not limited to the following: + Maintain accurate files and filing systems to include operations documentation and other miscellaneous documents. + Write, type, ... abuse form, photos of the load, and applicable TTR report to the RDC Claims Coordinator for product disposition. + Coordinate getting the pallet trailers moved to a… more
- Albany International Airport (Albany, NY)
- …and outside agencies. + Assists in the monitoring of the Glycol Containment System in accordance with the Best Management Practices guidelines. + Ensures compliance ... data for such incidents as property damage, personal injury claims , unusual occurrences, irregular operations (IROPS) and malfunctioning of machinery/equipment… more
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