- State of Indiana (Muncie, IN)
- …or challenging cases, problem solving, and problem resolution. + Approve a sampling of claims and all fiscal authorizations and claims over edit limits for VR ... client services. + Analyze spending patterns and develop strategies necessary for remediation with individual counselors. + Solicit ongoing input from staff, consumers, providers, and other community partners to maintain current understanding of program needs.… more
- LandPro Equipment LLC (Clarence Center, NY)
- …department tools, equipment, and vehicles in good working order + May submit warranty claims and return claims within the required time frame to receive maximum ... credits allowed + May perform recruiting, staffing, and employee development activities + Responsible for other duties as assigned by your manager Requirements Experience, Education, Skills, and Knowledge: + 1+ years experience in Parts Department operations +… more
- Insight Global (Los Angeles, CA)
- …management with specialized administrative tasks and projects. -Process forms and claims such as employment verifications, EDD forms/ claims , garnishments, and ... child support orders. -Prepare HR reports including attendance, new hire, and turnover metrics. -Reset system passwords and provide basic HRIS support. -Participate in meetings and group sessions as required. -Identify opportunities for process improvement.… more
- Performance Optimal Health (Stamford, CT)
- …and thrives in a collaborative environment. Responsibilities + Review and process patient claims and invoices accurately and in a timely manner. + Verify insurance ... insurance companies, patients, and internal staff. + Prepare and send appeals when claims are denied or underpaid. + Maintain complete and accurate patient records,… more
- The County of Los Angeles (Los Angeles, CA)
- …from being filtered as spam/junk/clutter mail. Los Angeles County will not consider claims of not viewing or receiving notifications to be a valid reason for ... applicant's responsibility to take steps to view correspondence, and we will not consider claims of missing notices to be a valid reason for rescheduling an exam… more
- Wells Enterprises (Le Mars, IA)
- …adequate risk transfer and insurance requirements are met. 5. Oversee claims management process, including reporting, investigating, documenting and resolving ... claims related to property, auto, transportation, employee, product, and general liability, working closely with legal counsel as needed. 6. Lead, mentor, and develop… more
- Humana (Albany, NY)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... with Optum WebStrat or PSI applications + Experience reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Highmark Health (Montpelier, VT)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician… more
- BrightSpring Health Services (Denton, TX)
- …personnel costs, consultant services, etc + Monitors worker's compensation and unemployment claims for assigned service site(s) + Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas + Other duties as assigned Qualifications + BA/BS in Business, Health Care Administration, or Social… more
- Elevance Health (Seattle, WA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as… more
Recent Jobs
-
System Administrator - EM Development & Testi
- BEAT LLC (San Antonio, TX)