- State of Colorado (Pueblo, CO)
- …Coloradans. What we do: Retail Operations provides the sale of Lottery products, claims processing, redemption of prizes, and customer service at the Pueblo, Denver, ... Grand Junction, and Ft. Collins Claims Counters, including providing customer service support to retailers,...from many levels within the organization and community. + Data Entry including: entering information into a program or… more
- University of Rochester (Albany, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working ... process taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative ...with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. + 10%… more
- University of Rochester (Rochester, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The claims resolution representative II is responsible for working ... include but are not limited to researching, correcting, resubmitting claims , submitting appeals and taking timely and...and taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative … more
- State of Colorado (Denver, CO)
- …dose cassettes). + Issues credits back to clients. + Process Medicare Part D claims . + Completes associated paperwork and computer data entry. Package and Fill ... of inventory for (near) outdated medication for removal and replacement, data entry, ordering and restocking pharmaceuticals and supplies, pre-packaging and labeling… more
- Amentum (Washington, DC)
- …Fund ("VCF") was created to provide compensation for any individual or personal representative of a deceased individual who suffered physical harm or was killed as ... claim review team work, with a particular emphasis on claim and data management, claim assessment, knowledge management and training coordination. Working closely… more
- PeaceHealth (Vancouver, WA)
- …Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement ... **Essential Functions** + Resolves insurance claim rejections/denials, and non-payment of claims by payors. + Identifies trends in billing and follow-up, in… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals . Their work goes beyond extraction; it ... with internal teams such as Network and Pharmacy, ensuring data is pulled using the most representative ...degree. * Knowledge of managed care and health care claims preferred. * Experience with Databricks preferred. Compensation and… more
- State of Colorado (Denver, CO)
- …contract compliance, and evaluating performance. + Review and approve/deny payment of claims for grant reimbursement of work and materials and evaluate overall ... both written and oral + Understanding of traffic safety data , trends, and analysis + Ability to influence, persuade...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- Iowa Department of Administrative Services (Cedar Rapids, IA)
- …contact work obtaining, analyzing and evaluating data such as job/ claims interviewing, testing, referral and/or placement, sales representative , credit ... contact work obtaining, analyzing and evaluating data such as job/ claims interviewing, testing, referral and/or placement, sales representative , credit… more
- Highmark Health (Montpelier, VT)
- …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
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- Scripps Health (San Diego, CA)