- Providence (OR)
- …specialty societies, and assists with implementation of such changes to the claims adjudication and editing software. **Providence Health Plan** caregivers are ... will also be considered. + 2 years of experience with Facets Claims Adjudication system and/or Optum CES editing software. **Salary Range by Location:**… more
- Independent Health (Buffalo, NY)
- …related phone calls. The COB Coordinator will also be responsible for basic claims adjudication , performing basic claim adjustments and working defined reports. ... maintain an acceptable level of production as outlined in the Claims /COB Performance Management Policy with minimal supervision and demonstrate basic problem-solving… more
- Ardon (Portland, OR)
- …software system work queues. Must be able to understand and interpret claims adjudication issues with Pharmacy Benefit Management organizations, insurance plans, ... any identified obstacles or improvements to workflow to operational leadership. Troubleshoots adjudication issues and is well versed in the nuances of insurance… more
- Saint Francis Health System (Tulsa, OK)
- …oversight to maximize cash flow, reduce accounts receivable days, and ensure effective claims adjudication . This position plays a key role in monitoring ... all aspects of patient financial services including professional and hospital claims billing, cash posting, and management of patient receivables. This role… more
- US Tech Solutions (Columbia, SC)
- …in data collection/input into system for clinical information flow and proper claims adjudication . Demonstrates compliance with all applicable legislation and ... provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate,… more
- Martin's Point Health Care (Portland, ME)
- …in Microsoft Outlook, Word, Excel, TruCare and Salesforce. Experience with QNXT Claims Adjudication Platform strongly preferred. Abilities + Exceptional written ... + Demonstrates advanced knowledge of enrollment / disenrollment guidelines, claims processing and plan benefits necessary to exercise decision-making authority… more
- Essentia Health (Superior, WI)
- …nursing staff, pharmacies, third parties, and software vendors to work through claims adjudication and processing issues to ensure payment from third-party ... Medicare rules are followed when processing Medicare B billed claims + Provide direct patient interaction by assisting patients...1 year experience as a pharmacy technician, medical assistant, claims representative in a managed care role or in… more
- US Tech Solutions (Columbia, SC)
- …in data collection/input into system for clinical information flow and proper claims adjudication . Demonstrates compliance with all applicable legislation and ... or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to… more
- Sharp HealthCare (San Diego, CA)
- …management team. + Knowledge of Federal and State regulations as related to benefit and claims adjudication . + Adept at being an initiator of positive change to ... and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit… more
- Movn Health (CA)
- …billing and A/R management + Deep knowledge of payer reimbursement methodologies and claims adjudication + Proficiency with multiple EHRs + Strong command of ... Biller & A/R Specialist to take full ownership of claims processing and accounts receivable recovery. This is a...payer systems is essential. Functional Responsibilities + Submit clean claims via EHR to all payers within 24 hours… more