- MyFlorida (Largo, FL)
- …portals and websites. The Accountant IV incumbent is responsible for performing claims processing , posting payments and collection activities of the State ... QUALIFICATIONS: + One (1) year experience in third party health insurance claims , medical billing, and collections. + Excellent written and verbal communication and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …meetings with assigned payers and provider representatives to address all outstanding claims processing issues. Maintain an ongoing issues tracker for each ... Third Party Payer audits by obtaining information relative to all claims audited with regards to policies, departmental practices/processes, and procedures; to… more
- Trinity Health (Boise, ID)
- …ensure accuracy. + Accesses information and translates data into information acceptable to the claims processing system. + Prepares claims for return to ... and escalates to Supervisor, Patient Access. + Processes insurance claim forms. + Reviews claims /accounts for complete information, corrects and completes forms to… more
- CareFirst (Baltimore, MD)
- …role. **Preferred Qualifications:** + Demonstrated experience with Excel, SalesForce, and claims processing systems. **Knowledge, Skills and Abilities (KSAs)** + ... payment requests. This includes the maintenance of the NSA tracking database and claims resolution from start to finish. Monitors claims , identify trends,… more
- Centene Corporation (Frankfort, KY)
- …fraud investigation experience. Knowledge of Microsoft Applications medical coding, claims processing , and data mining preferred. **Licenses/Certifications:** ... and abuse activity. Assist in planning, organizing, and executing special claims investigations or audits that identify, evaluate and measure potential healthcare… more
- CVS Health (Harrisburg, PA)
- …in a cost effective manner - Knowledge of CVS Health (or other PBM) claims processing - Knowledge of retail pharmacy operations including reading prescriptions ... role, you will be based from your home and travel onsite to conduct claims audits at pharmacies throughout multiple states by reviewing prescription claims … more
- PRGX (Grand Rapids, MI)
- …accounts payable operations, or vendor contract terms. + Prior experience in recovery audit or claims processing is a plus. What We Offer + Opportunity to work ... methodologies, you'll investigate payment processes, detect discrepancies, and prepare claims with clear documentation. This role requires strong analytical skills,… more
- AdventHealth (Maitland, FL)
- … claims analytics Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical economics Proficiency in ... using knowledge of healthcare managed care contracts and administrative claims data. + Employs existing complex models and implements...understanding professional and facility claims and managed care concepts such as risk adjustment,… more
- Snapsheet (Chicago, IL)
- …that drive efficiencies using data and technology to enable the fastest and most accurate claims processing in the industry. We are looking for a Senior Software ... Engineer to join one of two core teams at Snapsheet: Claims Management Team Our Claims Management team develops cutting-edge solutions for our main SaaS product,… more
- Elevance Health (San Juan, PR)
- …within the enterprise. Included are processes related to enrollment and billing and claims processing , as well as customer service written and verbal inquiries. ... management. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries,… more