- Humana (Charleston, WV)
- …Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery . The ... offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development &… more
- Penn Medicine (East Petersburg, PA)
- …the resolution of the denied claim. + Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve denied claims . + ... with any special projects as assigned. Credentials: Education or Equivalent Experience: + Associate of Arts or Science + HS Diploma/GED (Required) We believe that… more
- MyFlorida (Tallahassee, FL)
- …fall within the Bureau's responsibility: Operations, Data Detection, Investigations, Overpayment Recovery , and Managed Care oversight. MPI operates with dynamic and ... as engage in other prevention activities, including pre-payment reviews, paid claims reversals, site visits, identifying and processing sanctions of providers,… more
- CVS Health (St. Paul, MN)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... the recovery of company and customer money lost as a...a timely basis. **Education** - Bachelor's degree and/or an Associate 's degree with three additional years working in health… more
- Avera (Sioux Falls, SD)
- …identify root causes, and recommend process improvements. + Manage appeals for underpaid claims , track outcomes, and report on recovery efforts and payment ... the employer. **Required Education, License/Certification, or Work Experience:** + Associate 's in Healthcare Administration, Finance, Business Analytics, or related… more
- City of Chicago (Chicago, IL)
- …that are outlined in electronic database . Reviews treatment and recovery progress information, communicates with the involved department member and schedules ... are acceptable: o Graduation from an accredited college or university with an associate 's degree or higher, plus one (1) year of experience providing medical case… more
- State of Massachusetts (Braintree, MA)
- …procedures as properly requested and authorized by the Security, Compliance, and Claims Departments. * Assist the Supervisors with the Install of software updates ... and perform routine maintenance such as weekly takeovers and quarterly Disaster Recovery testing to backup data center. * Process Lottery drawings by entering… more
- UNUM (Chattanooga, TN)
- …reviewing, analyzing and interpreting medical information. Works collaboratively with claims professionals, on-site physicians and other resources in multiple ... action steps. Collaborates with healthcare providers to clarify functional capacity, recovery expectations, treatment plans and initiate return to work plans where… more
- Conifer Realty LLC (Rochester, NY)
- …with Risk Management on incident reporting, property loss prevention, and claims mitigation. Inspections & Compliance + Ensure all properties maintain full ... regional emergency response initiatives, assisting in the preparation, response, and recovery from natural disasters and facility emergencies. + Ensure properties… more
- Geisinger (Danville, PA)
- …system, including the areas of billing, accounts receivable, capitation payable, claims payable, weekly check processing, new product development, and the ... implementation of billing and capitation system upgrades. + Assists with disaster recovery testing. + Receives, analyzes and recommends appropriate action on user… more