- Essentia Health (Brainerd, MN)
- …claims to payers with full and complete information to satisfy and facilitate the claim for payment. Produce accurate and timely claims in order to prevent ... for working assigned work queues within the patient accounting system and claim scrubber edits prior to...other regulatory changes affecting the billing of health insurance claims and making recommendations regarding billing and system… more
- Molina Healthcare (Houston, TX)
- …all payment integrity (PI) solutions. * Independently leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial ... Analysis_ * Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. * Applies understanding of… more
- MAPFRE Insurance (Webster, MA)
- …Damage Department. In this role, you'll ensure exceptional customer service, accurate claims investigation, and timely settlements. You'll also play a key role in ... Service** + Supervise adjusters handling first- and third-party physical damage claims under personal and commercial auto policies. + Monitor staffing levels,… more
- Guidehouse (Minneapolis, MN)
- …of assigned Medicare and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. ... include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific...Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as assigned + As needed, review… 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 ... (eg, HIPAA, CMS, utilization management standards) + Experience with EHR/EMR systems , payer portals, or access control tools + Excellent communication and… more
- Commonwealth of Pennsylvania (PA)
- …operating and contracted provider expense information for entry into the accounting system 's budget module. Utilizing both automated and manual accounting tools, you ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....BEHAVIOR 4 - COMPLIANCE Provides a uniform and cost-effective system of accounting and financial controls to ensure accountability… more
- Commonwealth of Pennsylvania (PA)
- …questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are ... Select the "Level of Performance" which best describes your claim . + A. I have experience conducting investigations of...information secured during the interviews utilizing SAMS information technology system or a similar database. + B. I have… more
- Commonwealth of Pennsylvania (PA)
- …residents in the youth development center/youth forestry camp (YDC/YFC) system . You will administer integrated rehabilitative services programs and implement ... questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are… more
- Commonwealth of Pennsylvania (PA)
- …within six months of hire: + IS-100.C: Introduction to the Incident Command System + IS-700.B: An Introduction to the National Incident Management System ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....Select the "Level of Performance" which best describes your claim . + A. I have experience providing technical assistance… more
- Modernizing Medicine (Boca Raton, FL)
- … claim states, and support the development of AI-driven decision support systems that recommend next-best actions throughout the claim workflow. Your Role: ... will focus on advancing intelligent automation across the clinical and healthcare claims data lifecycle. The intern will work with cutting-edge generative AI and… more
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