- Waystar (Louisville, KY)
- …environment + Working closely with internal and external resources to define system requirements that meet changing market needs and ensure customer satisfaction and ... is trusted by 1M+ providers, 1K+ hospitals and health systems , and is connected to over 5K commercial and...Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans.… more
- Humana (Raleigh, NC)
- …products, or other medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group practice ... management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG(R) or InterQual + Internal Medicine,… more
- Humana (Juneau, AK)
- …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group practice ... management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG(R) or InterQual + Internal Medicine,… more
- NTT DATA North America (Lincoln, NE)
- …+ **Benefit Calculation:** Calculate benefit amounts and process payments through the claims system . + **Fraud Detection:** Identify and flag potential ... organization, apply now. We are currently seeking a Business Systems Analysis Analyst to join our team in Lincoln,...required benefits.** **Role Overview:** We are seeking a dedicated Claims Case Manager to provide comprehensive claim … more
- Mount Sinai Health System (New York, NY)
- …:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight ... Mount Sinai is one of the largest US health systems with a strong reputation for quality of care...Facility and Ancillary Contracts across the Mount Sinai Health System . MSHP seeks a Senior Contract Compliance (Professional Billing)… more
- SERV Behavioral Health System (Hamilton, NJ)
- …for behavioral health services. + Responsible for both Medicaid FFS (NJMAPPS) and claims submission through the current EHR system . + Reviews and resubmits ... within the standard billing cycle timeframe. + Identifies corrected claims and process all claim appeals. +...in medical billing software and electronic health records (EHR) systems . + Strong understanding of medical coding (eg, CPT,… more
- University of Southern California (Alhambra, CA)
- …AIDX/GE and other systems Demonstrates knowledge in various payor websites. System Folder Notes / Account Documentation Documents claim bill date, billed ... claim . Analyzes the pre-printed information on the claim form(s) or billing system to ensure...reports for additional documentation to be attached to hardcopy claim forms. Transmits claims via electronic vendor,… more
- Atlantic Health System (Morristown, NJ)
- …and reviewing claim documents, coordinating interviews, and maintaining accurate claim files. The paralegal collaborates with claims managers, risk ... The Paralegal in the Claims Department supports the management of professional liability...solver* Self-motivated and interested in learning At Atlantic Health System , our promise to our communities is; Anyone who… more
- Whitsons Culinary Group (Islandia, NY)
- …of employees returning from injury. Reporting, Analytics & Compliance + Track and report on claim metrics including new claims , closed claims , open claims ... and interim responsibilities as requested. + Support insurance renewals, audits, and claims reviews. + Participate in system upgrades or reporting enhancements… more
- Mount Sinai Health System (New York, NY)
- …:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight ... pharmacist. Documents all patient encounters as appropriate in health system documentation system . 2. Data analysis: such.... 2. Data analysis: such as payer data and claim 3. Support the pharmacist to implement the patient's… more
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