- Commonwealth of Pennsylvania (PA)
- …resolution. Levels of Performance Select the Level of Performance that best describes your claim . + A. I have experience monitoring system hardware and software. ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....C. I have successfully completed college-level coursework related to system monitoring or systems management. + D.… more
- LA Care Health Plan (Los Angeles, CA)
- …Plan Core Systems applications, and databases (eg, QNXT Migration Utility, Claims Workflow, Claims Test Pro, NetworX Pricer, etc.). This position serves ... management testing and related best practices. Facilitate production controls and system configuration data codification. Monitor and review systems edits,… more
- Ventura County (Ventura, CA)
- …extensive analysis and research through the use of multiple electronic health record (EHR) systems such as Cerner, HURON, and/or Claim Source to follow up on ... Care and Commercial Insurance billing + Experience with multiple electronic health record (EHR) systems , such as Cerner, HURON, and/or Claim Source to follow up… more
- UIC Government Services and the Bowhead Family of Companies (Dahlgren, VA)
- …BMD supporting maintenance, operation, and the tactical employment of the SPY Radar System and Aegis Weapon System . + Develops, tests, maintains, and delivers ... training programs and related materials in support of Surface Combat Systems Training Command (SCSTC) ATRC training objectives. + Teaches approved course content and… more
- St. Luke's Health System (Boise, ID)
- …and third-party issues such as prior authorization, step therapy, reviewing denied claims , and processing overrides. Works with an interdisciplinary team of pharmacy ... under the pharmacy benefits. + Facilitate resolutions to issues involving claims adjudication, member concerns, and provider communications. + Addresses complex… more
- Sharp HealthCare (San Diego, CA)
- … claims , provider, billing, capitation, financial and structural. The Systems Analyst-EDI Mgmt will work to streamline processes, create efficiencies and ... + Associate's Degree + 2 Years Direct experience in project planning and system implementation. + Experience as systems analyst within a large Health… more
- Covenant Health Inc. (Knoxville, TN)
- …between other Covenant departments in order to correct any issues with billed claims to ensure correct billing and proper claim processing. Position Summary: ... Overview Patient Account Representative - Insurance Claim Follow-Up Full Time , 80 Hours Per...Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than… more
- Johnson Thermal Systems (Abilene, TX)
- …practices using leading and trailing indicators. + Facilitates the workers' compensation claims process including initial entering of claim ; assisting in the ... adjusters, and investigators; and processing documents pertaining to the incident and claim . + Facilitate onboarding of new employees and various classroom and… more
- Sedgwick (Salem, OR)
- …+ Receive and review new claims and maintain data integrity in the claims system . + Conduct claim file activities including evaluations, investigations, ... your adjuster knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...+ Prepare settlement documents and requests payment for the claim and expenses. + Work with external vendors and… more
- Sedgwick (Raleigh, NC)
- …of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for ... Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client… more
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