- Elevance Health (Grand Prairie, TX)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... duties may include, but are not limited to:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the… more
- University of Michigan (Ann Arbor, MI)
- …candidate will manage, clean, and analyze administrative datasets (eg, Medicare claims , prescribing, and corporate ownership data); write reproducible code in Stata, ... Actions: Clean, organize, and link large administrative datasets (eg, Medicare claims , prescribing data, and corporate ownership data) from multiple sources. Develop… more
- Idaho Division of Human Resources (Boise, ID)
- …processing. + Analyze, audit expenditure transactions, including purchasing cards and travel claims . + One of the final reviewers of expenditures, purchasing cards ... and travel claims with a responsibility for ensuring compliance with statute,...and approved by Financial Executive Officer or the Administration Administrator . Auditing - + Review audit reports regarding receipts,… more
- Elevance Health (Tampa, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Commonwealth of Pennsylvania (PA)
- …Human Resource Analyst 1, you will be responsible for managing medical with lost time claims , modified duty, and indemnity claims for a specified period of time. ... the opportunity to work with the contracted workers' compensation third party administrator (TPA) and Bureau of Commonwealth Payroll to develop case strategies for… more
- Elevance Health (Seattle, WA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- ATI (Dallas, TX)
- …initiatives across the Law Department. Key Responsibilities: Litigation Support & Insurance Claims Management + Assign matters to outside counsel and serve as the ... tracking. Insurance & Risk Management + Handle tendering of claims to insurers and coordinate responses to insurer inquiries...and compliance matters as needed. + Serve as system administrator and primary point of contact for document management… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis, and medical record reviews of complex claims and ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
- Penn Medicine (Philadelphia, PA)
- …life's work? Summary: + Under the supervision of the Business Operations Administrator , the Transplant Billing and Accounts Payable Specialist is responsible for ... vendor agreements and terms. This position supports the Business Operations Administrator in expense review activities weekly to identify issues and trends,… more