- UPMC (Pittsburgh, PA)
- …is key to keeping operations running smoothly. + Verify electronically received claims before adjudication , clearing errored records in line with established ... things run smoothly and accurately? As a Document Process Specialist , you'll be at the front line of our..., you'll be at the front line of our claims intake process-ensuring that every paper claim and piece… 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 ... to Work" since 2015. Position Summary The Appeals Quality and Training Specialist supports the Appeals Department. This role supports Appeals quality goals through… more
- US Army Corps of Engineers (Seattle, WA)
- …Business Administration, and state regulatory agencies. Oversee the processing of contract claims and disputes arising under the Contract Disputes Act. Oversee and ... about transcripts is in this document. Basic Requirement for Contract Specialist : Degree: Bachelor's degree (or higher degree) from an accredited educational… more
- Molina Healthcare (NE)
- …Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- …and/or convenience if required. Manages contractor requests for equitable adjustments and adjudication of contractor claims . Develops documents for legal review ... Title: SENIOR FACILITIES CONTRACT SPECIALIST Location: United States-Virginia-Virginia Beach Job Number: 2500008Y...Salary Code 5A. Acts as the Senior Facilities Contracts Specialist performing all duties related to the planning, development,… more
- State of Massachusetts (Boston, MA)
- …part-time, professional experience in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational ... is seeking qualified applicants for the position of *Ombuds Specialist *. Our ideal candidate will provide a high level...all Domestic Violence issues to the appropriate Domestic Violence specialist immediately. * Ensure all clients are made aware… more
- Billings Clinic (Bozeman, MT)
- …of medical insurance claims experience through patient accounts billing or claims adjudication Billings Clinic is Montana's largest health system serving ... to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Authorization Specialist (Full-time) PRE-ACCESS (BILLINGS CLINIC BOZEMAN AMBULATORY) req10316 Shift:… more
- St. Luke's Health System (Boise, ID)
- …under the pharmacy benefits. + Facilitate resolutions to issues involving claims adjudication , member concerns, and provider communications. + Addresses ... truly a great place to work. **Overview:** The Senior Pharmacy Benefits Specialist assists our members in identifying and navigating complex pharmacy benefits… more
- UPMC (Pittsburgh, PA)
- …and continuing education activities. Preferred Experience: Experience with claims adjudication , therapeutic substitution interventions, dose optimization ... UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Prior Authorization Team within the Pharmacy Services department. This is a… more
- Datavant (Hartford, CT)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... practices, and proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing, utilization review,… more