- Fairview Health Services (St. Paul, MN)
- …processes. Provides subject matter expertise on technical and compliance areas that impact claims processing including EPIC HB system , and payor requirements. + ... in compliant and trusted outcomes for patients, providers, workforce and system . Overall responsibilities include development and oversight of operational metrics,… more
- University of Southern California (Arcadia, CA)
- …errors promptly and accurately. + Correct any errors promptly and have the claim resubmitted if needed. + Displays professional commitment and supports the unit team ... contractual adjustment on the account and have a corrected claim submitted to the insurance carrier in a timely...the patient account note area within the current computer system . + Maintain productivity report for accounts within assigned… more
- Manulife (FL)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... management and Requesters + Optimally applies internal case management systems to keep department management updated and to plan...and trains more junior investigators on long term care claim cases and processes + Ability to travel on… more
- Aston Carter (Lombard, IL)
- …group rebate claims . + Create AP bill-backs in Blacksmith and review claims for proper disposition. + Investigate unauthorized claim amounts and ensure ... Blacksmith, and maintain all deductions in the Blacksmith Deduction Management system . Your role will involve collaboration with accounts receivable, customers,… more
- BrightSpring Health Services (Union City, CA)
- …+ Triage, interpret and input orders into computerized medication order system while meeting accuracy and productivity standards of the pharmacy. Audits ... resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) + Maintains current...of Sale (POS) + Maintains current knowledge of Medicaid claim regulations and processes + May produce reports and… more
- Zelis (NJ)
- …quality assurance program to ensure accurate results to our clients + Manage assigned claims and claim report, adhering to client turnaround time, and department ... across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with...achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10… more
- BrightSpring Health Services (Wilkes Barre, PA)
- …+ Triage, interpret and input orders into computerized medication order system while meeting accuracy and productivity standards of the pharmacy. Audits ... resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) + Maintains current...of Sale (POS) + Maintains current knowledge of Medicaid claim regulations and processes + May produce reports and… more
- Southland Industries (Carrollton, TX)
- …tool box talks. + Process supervisor's first report of injury. Set-up and maintain w/c claim filing system . + Assist with case management of open claims ... Brandt's/Southland safety department, with heavy emphasis on workers compensation claims management. **Position Details** + Provide administrative support to group… more
- Community Health Systems (Franklin, TN)
- …Root Cause Analysis: Investigate and diagnose data errors originating in Oracle system configurations (EBS or Fusion), ensuring the integrity of critical data points ... Variance analysis (linking supply cost to procedure type) + Claims Denial Rate Analysis linked to operational inputs +...the overall health and financial performance driven by Oracle system outputs. 3. Advanced Modeling and Process Optimization +… more
- Space and Naval Warfare Systems Command (Charleston, SC)
- …and questions. You will assess performance, feasibility, and operational suitability of new system concepts with a focus on the value and utility in increasing ... when selecting individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit supporting documentation… more