- Insight Global (San Diego, CA)
- …or GED required. o Minimum 1+ year experience in healthcare, Medicare, or claims processing . o Intermediate Excel skills (formulas, VLOOKUP, pivot tables). o ... weekly PDE cycle submissions (previously 3-week cycles). o Convert claims data into CMS-compliant PDE files using internal systems....files for submission to CMS vendor (CSSC). * Data Processing & Reporting o Manipulate Excel files for cycle… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in healthcare contract variance analysis, including an in-depth knowledge of healthcare claims processing -OR- * An approved equivalent combination of education ... Skills/ Abilities:*/ * Excellent problem solving skills * Knowledge of EPIC claims processing systems and electronic health records * Must have skills in data… more
- Humana (Oklahoma City, OK)
- …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Assist in developing FWA education to ... (Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development + Experience in a… more
- Armed Forces Benefit Association (Lincoln, NE)
- …beneficiaries. + Communication and Coordination: Effectively communicate with insureds regarding claims processing and coverage changes, and coordinate with ... position is among our most visible and important roles, responsible for processing and responding to all insurance inquiries and completing appropriate actions to… more
- Queen's Health System (Honolulu, HI)
- …highly desirable. B. EXPERIENCE: * One (1) year experience in medical insurance claims processing or billing. An Associate's or Bachelor's degree in business ... field may be substituted for one (1) year experience in medical insurance claims processing or billing. * Prior recent billing experience in an acute care… more
- Amentum (Washington, DC)
- …Expected duties may include the following: + Scan and copy incoming materials related to claims processing . + Data entry from paper document into the database. + ... Technicians to assist with the the Radiation Exposure Compensation Act (RECA/Downwinders) claims team. The Document Management Technician role is crucial in ensuring… more
- Baylor Scott & White Health (Temple, TX)
- …pharmacy benefits, assist with understanding the prior authorization process, and resolve claims processing and eligibility issues while adhering to department ... THE ROLE** Helps members by phone or in writing to effectively resolve claims processing issues for all Health Plan products, utilizing pharmacy claims … more
- OLV Human Services (Lackawanna, NY)
- …standards. A critical part of the role involves evaluating insurance coverage, managing claims processing , and ensuring all aspects of patient care are ... with Finance to ensure patient charts are updated appropriately, if claims are denied/rejected. * Implement and maintain systems for insurance verification,… more
- Covenant Health Inc. (Sevierville, TN)
- …student-athletes. Schedule management for team practices, games & tournaments. Insurance claims processing for the student athlete medical care program. ... claims , and billing statements. + Incumbent oversees the coordination and processing of medical insurance plans through the claims process. Assists the… more
- DATAMAXIS (Springfield, IL)
- …to make determinations relating to complex processes involving claims processing /adjudication, recipient/provider eligibility, and third-party liability. ... in projects like the following: CMS Federal Reporting, quality measures, claims processing , Medicaid program eligibility, provider enrollment, third-party… more