- Covenant Health Inc. (Knoxville, TN)
- …Customer Service, Collections, Payment Posting) as it pertains to plan eligibility, claims processing details, and patient balance explanations as needed. + ... + Provides accurate explanation to patients with questions related to claims processing , plan benefits, and account balances via verbal and written… more
- MyFlorida (Fort Lauderdale, FL)
- …and determining managed care compliance with the SMMC contract as it relates to claims processing . Examples of work include: Analyzes programmatic reports of ... plans related to compliance with contract provisions, provider reimbursement and claims processing requirements. Maintains up-to-date knowledge concerning the… more
- Humana (Lincoln, NE)
- …+ Develop and recommend controls and cost-effective approaches to minimize claims processing risks. + Will perform advanced administrative/operational/customer ... and institutional claims reimbursement + Strong knowledge of TRICARE policy and claims processing + Able to work 8 hour shift between the hours of 7 am… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... business analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition to Level I Qualifications) .… more
- HCA Healthcare (Nashville, TN)
- …the Data management team. The Data Management team is responsible for ensuring that claims processing platform is optimally and accurately configured to meet the ... technical professionals. **Duties include, but not limited to:** + Ensure claims processing platform is optimally and accurately configured and maintained to… more
- Molina Healthcare (Bridgeport, CT)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Public Consulting Group (St. Paul, MN)
- …through claim issue research. Additional this position will assist in performing claims processing , medical record audits for all implemented agencies, and ... claim issue research. Additional this position will assist in performing claims processing , medical record audits for all implemented agencies, and assist with… more
- Sedgwick (Bartlesville, OK)
- …team meetings and assigns accountability for follow-up items. + Gathers important compliance/ claims processing information to be presented at team meetings. + ... **PRIMARY PURPOSE:** To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure workers'… more
- Masonicare (Wallingford, CT)
- …established procedures. - Works with - operations to resolve - issues that impact claims processing . Brings problems and delinquent responses to the attention of ... Manager. Process- corrections - and generate- claims for re- processing . - - Reviews denials and zero pay claims from payor remittance advices, research… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... contract language to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract terms are being adhered to in… more
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