- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the Bronx-Lebanon Hospital Center (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient… more
- Ryder System (Hagerstown, MD)
- …received and performed quality audits, review root cause analysis of damage claims , and participate with the potential to lead continuous improvement projects. ... **Essential Functions** + Analyze and Root Cause Non-Conformances and Damage material + Participate in continuous improvement projects, may lead projects as directed + Map and document processes + Participate in Quality Management Review + Perform Account… more
- Mohawk Valley Health System (Utica, NY)
- …and uses them as a contact when necessary to resolve outstanding issue on claims . + Determines whether payment from insurance billed is accurate, based on DRG, ... Contracted Rate, Per Diem, or Fee Schedule. Initiates an adjustment, if necessary, to bring account to the correct balance. Demonstrates thorough knowledge of rates for specific payor responsibility and advises management of any trends regarding inappropriate… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the Bronx-Lebanon Hospital Center (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient… more
- Robert Half Accountemps (Fayetteville, NC)
- …play a vital part in managing billing operations and ensuring that all claims are processed accurately and efficiently. This is an excellent opportunity for someone ... of a healthcare facility. Responsibilities: * Prepare, review, and submit medical claims to ensure accurate billing and timely reimbursement. * Verify patient… more
- Nuvance Health (Danbury, CT)
- …and accounts receivable functions. Responsible for the assigned areai? 1/2s claims submission, payment application, denial management, and account follow-up to ... ensure optimal reimbursement. Responsibilities: 1. Accurately processes claims , payments, rejections, refunds, credit balances and unapplied cash on a daily basis… more
- Sedgwick (Chicago, IL)
- …payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Aston Carter (Naperville, IL)
- …+ A minimum of a year of office experience in data entry, dispatchers, claims , or provider relations. (Open to entry level Bachelor's Degree candidates as well). + ... This position is responsible for the review, investigation, and evaluation of claims to determine eligibility and negotiate resolutions in compliance with all… more
- AmeriHealth Caritas (Philadelphia, PA)
- … claims experience and auditing experience + Minimum of 3 years of system configuration experience + Facets claim processing knowledge required + Microsoft ... will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all... affected by the configuration change and analyze all claims to ensure that all outcomes are accurate based… more
- FLACRA (Newark, NY)
- …and payment collection processes. This position is responsible for processing claims , managing accounts receivable, and ensuring timely and accurate payment ... school diploma / GED. Job Requirements: Key Responsibilities: + Process claims , including handling clearinghouse rejections and resubmissions. + Resolve claim… more