- Northwell Health (Lake Success, NY)
- …time off. In this role you will be ensuring timely and accurate claims processing, managing denials, and assisting with billing-related reporting and audits. This is ... the office. Requirements: * 5+ years of experience in medical billing and claims processing, and insurance follow-up. * Certification in medical billing and coding… more
- HTC Global Services Inc (Berlin, NH)
- …and payer processes. A typical description emphasizes collaboration with Enrollment teams, Claims and provider domains , and IT teams to translate complex healthcare ... adjudication and settlement. This includes both Medical and pharmacy claims . + Understanding of the provider domain and its...of the provider domain and its relationship with the claims processing. + Data Management: Design and maintain data… more
- CVS Health (Cumberland, RI)
- …by maintaining quality control over individual enrollment applications and resolving claims issues within the corporate billing system. This role maintains ... key metrics such as DSO, cost to collect, aged claims , and bad debt. **What you will do** +...+ Conducts research and analysis of trends related to claims , providers, and clinics to identify opportunities for process… more
- LA Care Health Plan (Los Angeles, CA)
- …or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document ... stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data… more
- Billings Clinic (Billings, MT)
- …with prescribed tablets/capsules, processing prescriptions and emergent prescriptions, adjudicating claims , performing point of sale functions, proper utilization of ... a neat and organized condition. * Processes complete prescription claims including proper adjudication/reconciliation, insurance verification, prior authorization, and… more
- City of New York (New York, NY)
- …enforcement tools to address allegations of discrimination. In addition to investigating claims of discrimination brought to the agency by members of the public, ... Responsibilities include: - Interview members of the public alleging claims of discrimination; engaging in effective pre-complaint interventions, thorough… more
- Percepta (Melbourne, FL)
- …of family and teamwork. Like the TSR role, the LTSR will support incoming dealer claims as well as escalated claims while assisting with floor coaching and ... member. * Provide real-time technical assistance to reduce the total number of claims requiring technical escalation and reduce the total number of contacts per… more
- Omnicell (Fort Worth, TX)
- …forms and documentation. . Communicate any issues that may arise, including claims disputes. . Oversee development and communication of customer reports. . Partner ... the design of necessary accounting protocols for submission of payment and claims posting activities. . Quickly and accurately answer customer questions; route… more
- Defense Logistics Agency (Fort Belvoir, VA)
- …including advising on contract modifications, disputes, requests for equitable adjustment, claims , and termination actions. Assists the Department of Justice in ... including bid protests and contract disputes filed at the Court of Federal Claims . Assists DCSO personnel with respect to internal and external reviews and audits,… more
- MetLife (Oriskany, NY)
- …professional medical, technical, consulting advice, and recommendations in support of claims evaluation, investigation and assessment for various claims -related ... years clinical experience. . Current RN licensure. Preferred: . 7+ years Disability claims and/or clinical experience. . Disability claims experience . Preferred… more