- Mount Sinai Health System (New York, NY)
- …required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ... secondary balances to appropriate financial class and provides documentation for processing the claims . 6. Reviews Credit Letter Sent (CLS) and transfers balance… more
- State of Minnesota (St. Paul, MN)
- …care policy, rules, laws and requirements that allow for submission and reimbursement of claims adjudicated the Medicaid claims processing system. + Resolve ... Working Knowledge of MN DHS Licensed providers + An understanding of claims processing operations, edits, and CPT coding practices sufficient to understand the… more
- Molina Healthcare (Kenosha, WI)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... experience **Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims payment method. **Preferred Education**… more
- Insight Global (Eden Prairie, MN)
- …known or identified claim issues in production o Resolve escalations o Capture claims processing requirements per contractual and business partner needs along ... Job Description An employer is looking for a highly-skilled remote claims focused Capability Manager to join one of our largest national healthcare clients for a… more
- MyFlorida (West Palm Beach, FL)
- …liaison with VA outpatient staff regarding case development and treatment to support claims processing and advocacy issues. Confer with clinic, service center ... / resume. + Three (3) years' employment experience as a Veterans Claims Examiner or comparable title / experience counseling and handling veterans' affairs.… more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians claims /accounts and takes necessary action to ensure timely and appropriate claim… more
- TEKsystems (Los Angeles, CA)
- …experience with HMO/Medicare claims , audits, and denials + Familiarity with claims processing systems (EZCap or similar) + Strong analytical, documentation, ... Job Title: Retro Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation:...LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is responsible for auditing and reviewing medical… more
- Covenant Health Inc. (Knoxville, TN)
- …codes, modifiers, charging units, physician's NPI, and HCPCS/CPT codes, to facilitate claims processing in a timely manner. Identifies trends and investigates ... Demonstrates expanded knowledge of the billing requirements for UB and 1500 claims for acute care facilities and professional services. This position is responsible… more
- Martin's Point Health Care (Portland, ME)
- …waste, and abuse investigatory techniques and strategies + Solid understanding of standard claims processing systems, operations, and claims data analysis + ... claim payments. This role focuses on preventing overpayments, identifying incorrect claims , and leading recovery efforts while improving system controls and… more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians claims /accounts and takes necessary action to ensure timely and appropriate claim… more