- KPH Healthcare Services, Inc. (Camden, NY)
- …for collecting, posting and managing account payments. + Prepares and submits claims to various insurance companies and follow up when appropriate. + Prepare, ... review and issue patient statements. Resolve patient billing complaints/issues. + Performs various collection actions. + Maintains strictest confidentiality, adheres… more
- Surgery Care Affiliates (Long Beach, CA)
- …selected for Primary insurance. + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits ... guidelines in contacting patient's prior to the date of service to review , Physician Ownership, Advance Directives and Patient Rights. Authorization: + Obtain… more
- The County of Los Angeles (Los Angeles, CA)
- …information concerning new or revised procedures. + Works with Professional Standards Review Organization representative to orient new staff to Federal laws ... UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply ...steps to view correspondence, and we will not consider claims for missing notices to be a valid reason… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Responsible for coordinating, processing and managing all in-patient and out-patient claims from a medical standpoint to ensure proper administration of contractual ... experience providing direct patient care with one year of authorization, medical review experience and case management is required **Skills and Abilities** +… more
- The County of Los Angeles (Los Angeles, CA)
- …as directed for medical care evaluation studies. + Works with Professional Standards Review Organization representative to orient new staff to Federal laws and ... UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply ...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be… more
- Festival Foods (WI)
- …available programs related to various lines of insurance are fully utilized. + Review company policies and emerging trends within claims to determine coverage ... to meet department objectives. Provides direct leadership to the Senior Claims Specialist and Workplace Safety Specialist. Prepares and delivers direct reports'… more
- University of Rochester (Albany, NY)
- …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative III is responsible for working ... process taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative ...to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and… more
- Ryder System (Augusta, ME)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- USAA (St. Louis, MO)
- …to ensure compliance with laws, regulations, and policy provisions. + Review claims /suppliers for fraud indicators and refers to Special ... require face-to-face interactions with members and third parties. + Review facts of loss and vehicle damage to determine...inspection. + May serve as a subject matter expert representative for disputed claims or trials. Serves… more
- St. Luke's University Health Network (Allentown, PA)
- …RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure ... care for appropriate reimbursement. + Work with the physician advisor in review of patient medical records identified by RAC/MIC/QIO and other governmental or… more