- Mass Markets (Garden City, GA)
- …services. Our contact centers are powered by both on-site and remote agents, leveraging advanced technologies to enhance customer journeys, drive scalability ... the below qualities: + High School Diploma/GED + Prior experience as a teller, associate , or in a banking role preferred. + Strong customer service orientation. +… more
- Trinity Health (Livonia, MI)
- …& HCC risk adjustment, ensuring compliance with reporting standards for claims submission. + Identifies patterns & trends impacting documentation & coding ... & billing regulations for assigned service area. **Minimum Qualifications** + Associate 's degree in Business, healthcare, Nursing or related field, or equivalent… more
- National Express (Worcester, MA)
- …for any missing or incorrect information that would prevent warrantable claims from being paid such as: missing Complaint/Cause/Correction comments, missing parts, ... is $60,000.00-$70,000.00 **Qualifications** . High School Diploma or equivalent - associate or bachelor's degree in a quantitative discipline preferred. . Two… more
- University of Rochester (Albany, NY)
- …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative III is responsible for working ... place where all can thrive. **Job Location (Full Address):** Remote Work - New York, Albany, New York, United...process taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative … more
- University of Rochester (Rochester, NY)
- …Payer Website link (EPIC Insurance Coverage tab), review payer website, or contact payer representative as to why claims are not paid. + Determines steps ... independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing issues. Maintain… more
- Ross Stores, Inc. (Dublin, CA)
- …of the Employment Law team primarily assessing, handling, and managing employment claims including defending Ross in agency hearings and in arbitrations\. This ... primarily working on optimal litigation results \(agency, individual, and representative actions\) with the potential for future work on...other employment law team members on the handling of claims and other tasks as assigned\. The base salary… more
- Humana (Oklahoma City, OK)
- …determination of the appropriate courses of action. The Provider Relations Representative is responsible for day-to-day front line relationship management for ... issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Minnesota Position Title: Care Advocacy Case Manager RN - Bilingual Spanish Location: Remote Career Area: Health Services About Blue Cross and Blue Shield of ... motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate , you are joining a culture that is built on values of succeeding… more
- AmeriHealth Caritas (Philadelphia, PA)
- …Research and analyze case documentation, including benefit coverage, prior authorizations, claims , and regulatory guidance. + Communicate with members, providers, or ... representative to clarify appeal intent and gather missing documentation...and Resolution_** + Collaborate with internal departments such as Claims , Medical Management, Legal, and Compliance to obtain necessary… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate , you are joining a culture that is built on values of succeeding ... synthesizes data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals. Their work goes beyond extraction; it… more