- CareFirst (Baltimore, MD)
- …of audits of financial business records, provider and subscriber medical data, claims , systems reports, medical records, analysis of contract documents, ... detailed offsite audits/investigations with interviews when appropriate. Researching provider/subscriber claims activity, operations manuals, data systems , medical… more
- University of Utah Health (Salt Lake City, UT)
- …**Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + Performs contract compliance on outstanding claims , ensuring ... dollar spreadsheets and/or payer escalations spreadsheets, as assigned. + Escalates claim issues internally to other key departments including Coding, Billing,… more
- Robert Half Accountemps (Van Nuys, CA)
- …to hear from you! Key Responsibilities: + Research, appeal, and resolve insurance claim denials to maximize reimbursement. + Review patient accounts to identify and ... address billing discrepancies. + Communicate with insurance companies to expedite claims resolution and payment collections. + Ensure compliance with relevant laws,… more
- Guardian Life (Holmdel, NJ)
- …Contracting, Underwriting, Claims and Operations. + Ensure that procedures and systems are updated as necessary and that changes are communicated to all ... partnership with provider contracting, legal, compliance, underwriting, network, and claims . Additionally, this individual will help identify, prioritize, and...interested parties. + Troubleshoot service, systems and claim issues and work with… more
- Sedgwick (Atlanta, GA)
- …preferred. **Skills & Knowledge** + Working knowledge of billing and reconciliation systems , claim systems , financial services, and insurance products ... or university preferred. **Experience** Four (4) years of experience in claims processing or related business experience, or equivalent combination of education… more
- Alabama Oncology (Birmingham, AL)
- …for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, ... explanations of benefits and exercises all options to obtain claim payments. + Reviews credit balance reports for correct...manner. + Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends… more
- UCLA Health (Los Angeles, CA)
- …This position plays a critical role in ensuring timely resolution of outstanding claims and contributes to the overall financial success of the organization. In this ... Manage an assigned portfolio of accounts across payer types, executing complex claim reviews, resolving payment delays, and optimizing collections strategy + Conduct… more
- Ventura County (Ventura, CA)
- …classification are responsible for researching and processing retirement benefit inquiries and claims on behalf of VCERA members. The ideal candidate must have the ... documentation on behalf of separated members including contribution refunds, rollovers, inter- system membership advice forms and deferred retirements. + Reviews and… more
- City of New York (New York, NY)
- …eligibility of Food Stamp benefits. - Verify the case folders for accurate claim establishment by accessing and checking the Welfare Management System (WMS), ... HRA One Viewer, IPay, Automated Listing of Eligibility Requirement Tracking System (ALERTS), collateral mailed inquiries, telephone contacts and other means for… more
- Beth Israel Lahey Health (Burlington, MA)
- …financial services activities including the HCPCS coding system , the ICD-9 coding system , revenue, claims , denials and collection practices. Must have a high ... estimates, collections for self-pay services, account initiation and coordination, claims submission, fee schedule maintenance, denials and customer service for… more