- Guidehouse (Minneapolis, MN)
- …this position include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity ... coding modifiers. + Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse...of CCI, MUE and Medical Necessity edits applied to claims . + Proficiency in determining accurate medical codes for… more
- Addiction Recovery Care (Lexington, KY)
- …supervision the Denials Resolution Specialist is responsible for resolving outstanding claims with government and commercial health insurance payers submitted on ... Key Responsibilities + Conducts root cause analysis of all assigned insurance payer claims and denials to determine appropriate actions required to resolve the claim… more
- J&J Family of Companies (Irvine, CA)
- …of evidence generation and dissemination activities that support product approvals, claims development, and product adoption and lifecycle management, and work ... data analysis, publication support and collection of data for supporting platform claims . + Contribute to the development and execution of product and/or procedural… more
- MyFlorida (Tampa, FL)
- …in the community to promote receipt of evidence for pending disability claims . + Contacts, informs and educates physicians, hospitals, clinics, and other ... the community to perform CEs and ancillary medical testing required to adjudicate claims . + Monitors CE scheduling trends to ensure timely appointments and works… more
- WestCare Foundation (Dandridge, TN)
- …Claim Preparation & Submission: Prepare and submit accurate and timely medical claims to insurance companies, government programs, and other payers. + Charge Entry: ... denial, and take appropriate action to correct and resubmit claims . + Billing Audits: Perform regular audits of patient...level of accuracy and attention to detail in processing claims and posting payments. + Communication Skills: Excellent verbal… more
- Sedgwick (Bedford, TX)
- …Automotive Customer Case Coordinators. We help auto customers through the manufacturing claims process. **_We offer benefits on day one:_** + **_401K_** + ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic claim vendor processing, ... is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to...by payors. Responsible to validate and accurately complete the claims identified with potential new payor plan coverage added… more
- World Insurance Associates, LLC. (Miami, FL)
- …and sending market RFP's, preparing renewals summaries, updating monthly claims reports, coordinating open enrollment, updating client deliverables and maintaining ... + Assists with setup of online benefits enrollment support tools. + Resolves claims or administrative issues on behalf of client, escalates claims issues… more
- Zurich NA (Houston, TX)
- …our customers, the candidate, and Zurich North America. At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it ... Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing employees to...be able to report into the following North American Claims office: Houston, TX or Dallas, TX In this… more
- Subaru of America (Pennsauken, NJ)
- …from draft to distribution). + Supports manager to provide information required in the claims system recall parameters to the SOA Claims team and composes the ... completion reports for SBR by compiling data from the SOA warranty claims system, relevant data from Oracle Business Intelligence (OBI), and information extracted… more