- HonorHealth (AZ)
- …solving. Reconciles complex, multi-payment accounts. Submits appeal letters on underpaid claims as directed. Interprets payer contracts to determine if payment and ... requirements for specified payors. Attends in-services/continued education + Interprets data processing reports and applies the information as needed for daily… more
- City of New York (New York, NY)
- …statutory, regulatory, and contractual standards. The Division of Financial Review and Processing (DFRP) is responsible for the initiation of adverse actions on cash ... of the Bureau of Fraud Investigation, Liens and Recovery, Claims and Collections and the Assistance Reimbursement Unit. Their...three Eligibility Specialist level III to function as Group Processing Workers, who will: - Confirm accuracy of data… more
- Cedar Rapids Community School District (Cedar Rapids, IA)
- …workers' compensation laws. + Manages the Incident reporting system with daily review of new claims and processing the claims to 3rd party vendor. Ensures ... for all leave of absence cases and workers' compensation claims . Effectively coordinates all cases/ claims to include...of work and maintain a highly organized system of processing documentation, employee contacts and notices. + Must maintain… more
- Rush University Medical Center (Chicago, IL)
- …the Senior Associate General Counsel and members of the Office of Risk and Claims Management (ORCM), this position is responsible for assisting in the oversight and ... management of professional and general liability suits and claims for Rush University Medical Center (RUMC) and Rush...CMS by RUMC/ROPH. + Reports required information in MMSEA processing software within the assigned 7-day reporting time period… more
- University of Rochester (Rochester, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The claims resolution representative II is responsible for working ... and taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative ...calls, payer website, and written communication to ensure accurate processing of claims . 15% + Follows established… more
- University of Michigan (Ann Arbor, MI)
- …approaches to Clinical Risk in partnership with the Insurance and Claims Administration Office investigation, processing , presentation and negotiation of ... clinical risk management programs and procedures to address medical malpractice claims arising from clinical care delivery. This executive role combines strategic… more
- Sedgwick (Southfield, MI)
- …CANDIDATE?** The Designated Litigation Manager acts as the pool client representative , oversees the pool's liability program, ensures the application of management ... costs. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Acts as the pool client representative . + Analyzes inquiries and provides guidance related to memorandums of… more
- Lithia & Driveway (Jacksonville, FL)
- …track each claim until its final resolution. + Contact the appropriate warranty claims representative regarding any claims requiring additional authorization ... they occur. + Check each repair order against the vehicles' service history to avoid processing duplicate claims or submitting claims for shop comebacks. +… more
- Transdev (Hillburn, NY)
- …Provide regular reports to local management staff of safety department efforts, claims status, training efforts, accident history, Workers' Compensation claims ... tracking of safety reports. + Assist the Safety Manager in working with corporate claims staff to ensure that all liability and Workers' Compensation claims are… more
- Essentia Health (Superior, WI)
- …assigned Required Qualifications: + 1 year experience as a pharmacy technician, medical assistant, claims representative in a managed care role or in a coding ... pharmacies, third parties, and software vendors to work through claims adjudication and processing issues to ensure...2 years' experience as a pharmacy technician, medical assistant, claims representative in a managed care role… more
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