- Zurich NA (Independence, OH)
- …will work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while ... on a hybrid basis. You will partner with your manager to set a flexible work schedule that supports...and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- J&J Family of Companies (Phoenix, AZ)
- …outside of promotional scope. + Educate appropriate clinical staff re: technical aspects of Spravato administration, monitoring, and adverse event management and ... processes (ie, eligibility and benefit verification, pre-authorization, billing, coding, claims , and appeals/grievances); REMs certification; Medicare and Medicaid rules… more
- J&J Family of Companies (Jacksonville, FL)
- …outside of promotional scope. + Educate appropriate clinical staff re: technical aspects of Spravato administration, monitoring, and adverse event management and ... processes (ie, eligibility and benefit verification, pre-authorization, billing, coding, claims , and appeals/grievances); REMs certification; Medicare and Medicaid rules… more
- Penn Medicine (East Petersburg, PA)
- …for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, ... or additional information if necessary, to expedite the resolution of the denied claim . + Performs all appeals and denial recovery procedures needed to appropriately… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** Under the direction of the Manager of EDI Management, the Systems Analyst-EDI Mgmt will use technical and ... Plan operational data sets including, but not limited to, eligibility, claims , provider, billing, capitation, financial and structural. The Systems Analyst-EDI Mgmt… more
- Highmark Health (Harrisburg, PA)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for education/training of… more
- Trinity Health (Fort Lauderdale, FL)
- …a. Perform coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review b. Responsible for proofing daily charges for accuracy ... and clean claim submission c. Responsible for balancing charges and adjustments...and charge entry. Other related responsibilities as assigned by manager . Minimum Qualifications: + High school diploma or equivalent… more
- Highmark Health (Harrisburg, PA)
- …functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness ... studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving. **ESSENTIAL RESPONSIBILITIES** + Define & diagnose a problem.… more
- Highmark Health (Harrisburg, PA)
- …functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness ... studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving. **ESSENTIAL RESPONSIBILITIES** + Develop efficient and transparent… more
- Zurich NA (New York, NY)
- …attracting top customer advocates who possess a sales mindset, strong technical underwriting skills and solution focused problem-solving abilities. Our industry ... an engaging team culture. This role requires a strong technical , staff development and sales execution mindset. This role...or AVP, Underwriting Mgr- Middle Market Level. The hiring manager will determine the appropriate level based upon the… more