- State of Arkansas (Little Rock, AR)
- …staff, claimants, employers, Reemployment Administration, and other UI units - including UI Claims Processing , UI Intake and Support, and UI Correspondence - ... experience working with the Reemployment Insurance program and general knowledge of claims processing and terminology. 2 years supervising Reemployment staff in… more
- SSM Health (Fond Du Lac, WI)
- …+ Processes the insurance component of a patient's obligation using the third party claims processing and payment rules. Bills claims appropriately. + ... Duties may include one or more of the following: processing insurance payments, following up on denied claims... processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple… more
- Robert Half Technology (Philadelphia, PA)
- …modify, and optimize database queries, stored procedures, and reports to support claims processing . * Monitor and improve system performance, availability, and ... within the claims database environment. * Collaborate with claims processing teams to understand workflows, data requirements, and reporting needs. *… more
- Molina Healthcare (Albuquerque, NM)
- …appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . * Validates member medical records and claims ... support for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit… more
- Molina Healthcare (San Diego, CA)
- …has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . * Evaluates medical records and/or medical notes ... **Job Description** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …and medical record reviews + Demonstrated analytical thinking skills + Knowledge of claims processing and adjudication by health insurers + Knowledge of health ... Prepayment Review Coding Specialist will conduct pre-payment reviews of claims submitted by providers and members to determine if...to substantiate the services billed. This process allows for claims to be reviewed prior to adjudication to ensure… more
- Adecco US, Inc. (San Juan, PR)
- …specifically in a complex and high-volume environment * Previous experience in claims processing and/or case management, particularly in Social Security, is ... Horizontes is a dedicated practice specializing in Social Security Disability claims . Our mission is to provide compassionate, expert assistance to individuals… more
- Trinity Health (Davenport, IA)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting or ... of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates… more
- AdventHealth (Maitland, FL)
- …all provider types Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical economics experience Proficiency ... sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
- North Carolina State University (Raleigh, NC)
- …medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing , and the policies and contracts of ... insured patients; obtaining and providing the clinical documentation necessary for claims processing , such as x-rays, chart notes, and letters of necessity; +… more