- CVS Health (Phoenix, AZ)
- …of exceptions identified during the audit process, specifically related to pharmacy claims . This includes having a working knowledge base around pharmacy claim ... + Previous internal/external audit experience. + 3 years experience with Pharmacy Claims + Proficiency in Excel, Teradata, Python, SQL, Word, etc. + Prior… more
- Insight Global (Woonsocket, RI)
- …and Requirements Experience in healthcare or insurance, specifically any Claims Knowledge and overall understanding, including provider/member/claim flow Proficiency ... including risks and issues, to senior leadership Ability to facilitate technical and business discussions effectively RTC experience Has managed teams within claims more
- UIC Government Services and the Bowhead Family of Companies (Dahlgren, VA)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. Please… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …communicates patterns and trends or professional and comprehensive general liability claims experience to the administrative and medical staff. + Makes ... concerning facility operation to reduce exposure to liability and insurance claims . + Receives, investigates, and provides resolution to patient grievances and… more
- AON (Charleston, SC)
- …with outside service providers, including actuaries, auditors, investment managers, brokers, claims adjusters and outside counsel to proactively meet client needs + ... with outside service providers, including actuaries, auditors, investment managers, brokers, claims adjusters and outside counsel to proactively meet client needs +… more
- Keith Titus Corp (Weedsport, NY)
- …details in Transman for onsite units and road service trucks. + Opens warranty claims , tracks & process, follow up on warranty shortages and claims requiring ... additional information/parts/pictures. + Develops estimates and communicate immediately 10% variance + Adept and proficient at Transman, TMW and all required Microsoft Suite tools used. + Adept and proficient with all shop related operating procedures,… more
- Advanced Orthopedics and Sports Medicine Institute (Freehold, NJ)
- …attorneys Schedules patient appointments including obtaining adjuster authorization for treatment for NJ claims and confirming NY claims are open and active for ... treatment, completes case manager screen and documents all insurance information necessary. Assist with creating WC intake forms prior to appointments Ensure the appropriate work comp intake information is documented prior to the initial work comp visit to… more
- Health Care Service Corporation (Nashville, TN)
- …application + . Member Collaterals + . Provider Credentialing - sCRED application + . Claims Intake process + . Claims Adjudication logic - FACETS application + ... . EOB + . Provider Payments - 835 remittance files & EOP + . CMS reporting + . SalesForce + . Evolve/Broker Test case management tools such as Zephyr** * Agile tool such as Jira/Rally * SQL * Health insurance or healthcare industry experience with emphasis on… more
- Sedgwick (Indianapolis, IN)
- …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 ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Robert Half Accountemps (Burlington, NC)
- …You will play a key role in ensuring timely payments, managing claims , and contributing to the overall efficiency of our financial operations. Responsibilities: ... related to billing inquiries and provide clear, accurate responses. * Administer claims and resolve discrepancies to maintain accurate account records. * Utilize… more