- AIG (Atlanta, GA)
- …established guidelines and authority, indemnity, and legal payments through the appropriate Claims Processing Systems . + Assist with ad-hoc duties, projects, ... valued member of the team. Make your mark in Claims Our Claims teams are the proven...adjusters to obtain and enter the information into appropriate systems . + Sell vehicles by monitoring the salvage site… more
- Mount Sinai Health System (New York, NY)
- …data models. + Extensive knowledge of healthcare/medical data such as hospital/physician claims , utilization data, and healthcare industry coding systems and ... Director of Revenue Intelligence for the Mount Sinai Health System (MSHS) and the Icahn School of Medicine at...System is one of the largest academic medical systems in the New York metro area, with more… more
- Syms Strategic Group, LLC (SSG) (Arlington, VA)
- …+ Implement continuous improvement methodology through the use of Information Technology (IT) systems or procedures + Maintain inventory of system assets + ... + Strong proficiency in Linux/Unix and Windows operating systems + Experience with system administration tasks...environments Desired experience Electronic Data Interchange X.12 (EDI) Medical Claims + X.12 medical claims (837, 834,… more
- MD Anderson Cancer Center (TX)
- …validate claim discrepancies. * Communicate with fiscal intermediary/MAC on claims issues. * Notify management immediately of all rejections or problems causing ... of the PBS Billing Specialist position is to bill and follow-up on Medicare claims within regulatory guidelines. The PBS Billing Specialist must ensure that all … more
- Molina Healthcare (Rio Rancho, NM)
- …and knowledge to research and resolve claim /encounter issues and pended claims , and updates system (s) as necessary. * Loads and maintains contracts, ... reference table information into the claims payment system and other applicable systems . * Participates in defect resolution for assigned component(s). *… more
- Molina Healthcare (St. Petersburg, FL)
- …and knowledge to research and resolve claim /encounter issues and pended claims , and updates system (s) as necessary. * Loads and maintains contracts, ... reference table information into the claims payment system and other applicable systems . * Participates in defect resolution for assigned component(s). *… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- … claims to Third party payers. + Submit claims to payers assuring claims meet the clean claim definition to assure timely and accurate payment. + Maintain ... to obtain preauthorization (in some departments), resolve outstanding balances, incorrect payments, claim denials or information needed to adjudicate claims . +… more
- Delta Air Lines, Inc. (Atlanta, GA)
- …suite of products, and SAP. + Ability to useInsurance Carrier/TPA data and claims management systems to analyze claimdata. + Understanding oftechnical claims ... in the education of internal businesspartners of the importance of early claim reporting, early return to workprograms and other appropriate cost containment… more
- Access Dubuque (Dubuque, IA)
- …detailed and accurate claim records, documentation, and communications in the claims system . + Partner with Safety, Maintenance, Operations, and Legal ... truck/trailer construction, damage assessment, and repair processes. + Experience with claims management systems and strong computer proficiency (Microsoft… more
- CareFirst (Baltimore, MD)
- …of losses to CareFirst through the clinical review of medical records and claims , resulting in the savings and/or recovery of funds. Responsible for providing ... investigations. **ESSENTIAL FUNCTIONS:** + Review of medical records and claims . Investigate potential fraud and over-utilization by performing complex...findings about the ability to pay or deny a claim or claim lines using clinical and/or… more