- CareFirst (Washington, DC)
- …This leader is responsible for developing and delivering system solutions for Claims Processing , Enrollment Operations and Customer and Member Services. Also, ... FUNCTIONS:** + Directs organization in defining application solutions for the claims processing , enrollment operations, and customer and member service… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance ... operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors.… more
- JBS USA (Greeley, CO)
- …of benefits programs and identify areas for improvement. Facilitate resolution for claims processing and administrative errors. Conduct periodic audits to ensure ... by meeting with clinical teams regularly. Oversee vendor relationships to ensure accurate processing of claims according to plan documents and adherence to… more
- Ardon (Portland, OR)
- …be able to accurately utilize applicable computer software and equipment for pharmacy claims processing . Working conditions Work is performed primarily at a ... Responsible for application tasks, including but not limited to: Processing incoming documents Maintaining patient records Loading insurance information Performing… more
- Molina Healthcare (Las Cruces, NM)
- …Ensure that provider information is loaded accurately to allow for proper claims processing , outbound reporting and directory processes. **JOB QUALIFICATIONS** ... for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims… more
- Molina Healthcare (Pittsfield, MA)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Knowledge, Skills & Abilities (must have): * Strong understanding of claims processing , reimbursement methodologies, and payment policies, with the ... team. Cross-Functional Collaboration * Work closely with network contracting, credentialing, claims , IT, customer service, compliance, and quality teams to address… more
- Intermountain Health (Murray, UT)
- …and Coding + Reimbursement + Billing Operations + Medical Billing Software + Insurance claims processing + ICD Coding + Patient Care + Medicare Billing ... The Medical Billing Specialist is responsible for the timely follow-up of claims billed and the resolution of accounts. Oversees the account receivables and… more
- CVS Health (Springfield, IL)
- … testing environment. + Working knowledge of PPO networks and healthcare claims processing . + Strong analytical and problem-solving skills. + Proficiency ... and contribute to test plan development. + Analyze and resolve complex claims scenarios within established timeframes. + Respond to internal and external customer… more
- McLaren Health Care (Flint, MI)
- …reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing , membership/eligibility, contracting and risk ... will include problem solving, eligibility, benefit, and resolution of claims issues. Assists in providing linkage to the Medical...for assisting members with eligibility, benefit, and resolution of claims issues as needed. **This is a fully remote… more
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