- Knowledge Builders Inc. (Albany, NY)
- …documentation is received prior to contract execution; * Assist Contracts team with claim reviews using financial system generated control points for of annual ... Work with agency fiscal staff and providers as necessary to resolve discrepancies in claims ; * Identify problem areas and trends and develop solutions; * Assist in… more
- Molina Healthcare (GA)
- …+ Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission. + Ability ... and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases...housed on databases and ensure adherence to business and system requirements of Health Plans as it pertains to… more
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- …within the Beneficiary Travel Department at the VA Northern Arizona Health Care System (NAVAHCS/Prescott). The incumbent will serve as a Team Lead and collaborate ... and audit invoices paid for accurate payment. Process Beneficiary Travel claims , Batch Reporting, Beneficiary Travel Reviewing Batch, Scheduling Special Mode… more
- Customs and Border Protection (Memphis, TN)
- …arising from seizures, penalties, prior disclosures, immigration carrier fines, and claims for liquidated damages. Typical work assignments include: Performing legal ... damages assessed under applicable laws and regulations. Reviewing and finalizing claims for liquidated damages and penalty cases. Preparing synopses of cases… more
- Ramsey County (St. Paul, MN)
- …clients who do not meet ongoing eligibility criteria. + Review vendor payment claims for accuracy, check claim amounts against established fee schedules, ... cases and monitoring case activities, reviewing and processing vendor payment claims , maintaining necessary files and records; informing trial witnesses when needed… more
- Actalent (Cary, NC)
- …possible care by effectively managing insurance communications, processing pharmacy claims , and assisting with various projects. Responsibilities + Recognize and ... + Enter all communication and documentation in the Biologics Management Information System (MIS). + Assist with projects such as yearly reverification. + Communicate… more
- The Hartford (Sunrise, FL)
- …Clinical and Vocational Rehabilitation Case Managers to work in the dynamic Group Disability Claims Offices to serve the needs of individuals who may not be able to ... will be responsible for reviewing ADA (leave), short term, and long-term disability claims for possible intervention / assistance with case management. The focus of… more
- Cardinal Health (Richmond, VA)
- …billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs) ... reason for patient responsibility. + Document all activities in the billing system according to departmental procedures. + Liaise with third party vendors supporting… more
- Actalent (Cary, NC)
- …manage communications with patients, triage prescriptions, and process pharmacy claims efficiently. Responsibilities + Recognize and effectively communicate about ... Enter all communication and documentation in the Biologics MIS system . + Assist with projects, such as yearly reverification....is unable to serve the patient. + Process pharmacy claims appropriately in Biologics MIS. + Recognize and understand… more
- Adecco US, Inc. (Irving, TX)
- …focused on supporting specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer ... high-impact reimbursement cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient access. 3.… more