- Shaw Industries Inc (Ringgold, GA)
- …continuous improvement, and serving as the primary liaison for customer claims and corporate quality initiatives. This role oversees quality systems, testing, ... standards creation. + Serve as the plant representative for customer claims , including communication with customers, reviewing returns, and coordinating with… more
- The Hartford (Hartford, CT)
- …protocol process when deemed clinically appropriate. Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure optimal outcomes. ... Determines when claims contain quality of care issues and escalates these...Manages risk and resources on highly complex behavioral health claims . Identifies appropriate return to work options and/or barriers… more
- Cognizant (Phoenix, AZ)
- …of experience to join our dynamic team. Your expertise in Medicare and Medicaid Claims will be crucial in ensuring efficient processing and management of claims . ... business needs. * Provide technical expertise in the Medicare and Medicaid Claims , Claims , and Payer domains. - Collaborate with cross-functional teams to ensure… more
- Surgery Care Affiliates (New Albany, IN)
- …timely and complete payments to our Practice. This position prepares and submits claims to insurance companies for medical services provided to patients. + Complete ... daily tasks of billing such as sending out claims , following up with carriers, and collecting patient payments....to date. + Submit accurate primary & secondary insurance claims to insurance providers following agency and payer guidelines.… more
- Teresian House (Albany, NY)
- …Care Organizations (MCO's) and private insurance. + Preparing and submitting claims , resolving billing issues, managing accounts receivable, and working with ... formats. Monitor and manage outstanding balances and follow-up on unpaid claims . + Communicating with families, residents and insurance companies regarding account… more
- Northern Light Health (Portland, ME)
- …for the development and ongoing review of hospital-wide clinical risk and claims management. The incumbent will assist the Director in coordinating in-depth risk ... education of hospital and medical personnel related to risk prevention and claims management. The Risk Management Specialist will participate in patient safety… more
- The Albany Auto Group (Miami, FL)
- …a Warranty Administrator you will be responsible for: -records -submitting warranty claims to the factory or distributor and reconciles them accordingly. -complete ... to ensure we are complying with manufactures and JLR policies. -Processes warranty claims on a timely basis for each franchise or distributor. -Processes all… more
- Mount Sinai Health System (New York, NY)
- …Proficient in these processes to facilitate accurate and timely payment of claims and collection. **Qualifications** + Associates Degree or high school diploma/GED ... + 2 years? experience in medical billing or health claims , with experience in Epic billing systems in a...these processes to facilitate accurate and timely payment of claims and collection. + Verifies insurance and registration data… more
- City of New York (New York, NY)
- …requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. 2. Claims Data Validation: Verify the ... accuracy, completeness, and timeliness of daily healthcare claims payment data submitted by the health plan prior...to authorize payment. Perform monthly reconciliations between the daily claims reports and the monthly reports which detail claim… more
- MetLife (Clarks Summit, PA)
- …goals and objectives. * Identify, remove, and challenge barriers related to claims management. Escalate to senior leaders in the organization as appropriate along ... correctly performing claim adjudication with the focus on Decisional, Financial, Claims Coding and Compliance Accuracy in accordance with the Customers' plan/policy… more