- The County of Los Angeles (Los Angeles, CA)
- …permanent appointment to Health Care Financial Analyst. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more
- UIC Government Services and the Bowhead Family of Companies (Dahlgren, VA)
- …future work + Working with SysAdmin/Cyber/AnA to maintain ATO readiness + Lead TOR Adjudication Meetings; CM to execute meeting flow and agenda + Accountable for all ... 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… more
- Hannaford (Bennington, VT)
- …claim forms. * Maintain organized filing system for invoices, manual insurance claims , daily reports, etc. in accordance with Standard Practice Manual and state ... in maintenance of third party prescription information and resolution of rejected adjudication . * Initiate prescription renewal requests to doctor via telephone call… more
- Insight Global (Raritan, NJ)
- …will provide oversight on all issues relating to rebate analysis and payments, adjudication of such payments on a timely basis and resolution of any disputes ... on rebate claims . Key Responsibilities: * Review and analyze data to process payments for outstanding disputes. * Deliver on expectations and activities to ensure… more
- Carle Health (Champaign, IL)
- …settlement and refund requests, bankruptcies, risk management and retro adjudication . Responsible for answering, documenting and completing inquiries from patients, ... healthcare liens, settlement requests, bankruptcies, bad debt, risk management, estate claims , fraud cases and attorney requests, etc. Handles escalated appeals.… more
- Insight Global (Eden Prairie, MN)
- Job Description Team: Be part of this enterprise-wide claims transformation journey! The The Claim Product and Data (CPD) team's vision is to reimagine and simplify ... Health Group, Optum, OptumRx -Experience with claim management and claim adjudication platforms -Significant experience working with IT in an agile environment… more
- Humana (Columbus, OH)
- …enforcement authorities. Assembles evidence and documentation to support successful adjudication , where appropriate. Conducts on-site audits of provider records ... CPC, CCS, CFE, AHFI). * Access * Understanding of healthcare industry, claims processing and investigative process development. * Experience in a corporate… more
- KPH Healthcare Services, Inc. (Malone, NY)
- …of pharmacy technology - included is product dispensing, data entry, and adjudication workflow step + Insure that every prescription has been checked by ... in the initial submission, and resubmission (as required) of all third-party claims + Inventory management - proficient in inventory management including ordering &… more
- UC Health (Cincinnati, OH)
- …& understanding of basic coding requirements + Understanding of Basic Payer adjudication concepts & Coordination of Benefits + Ability to read and understand ... Navinet, Anthem, Medicaid, Medicare) + Familiar with the function of a claims Clearinghouse and the actions they perform (Ie, Zirmend/Waystar, ePremis, etc.) +… more
- J&J Family of Companies (Irvine, CA)
- …the role will assist the study medical lead for clinical studies in adjudication of adverse events and concomitant medications. This position will require an ... of the preclinical & clinical evidence strategies to support clinical claims and participating in characterizing the product's capabilities and clinical workflows… more