- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE At Polaris Pharmacy Services, we're more ... it most, we invite you to grow with us. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy … more
- Cardinal Health (Boise, ID)
- …- 3:30 PM PST (or based on business need)** **_What Accounts Receivable Specialist contributes to Cardinal Health_** Account Receivable Specialist is responsible ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- LA Care Health Plan (Los Angeles, CA)
- …feedback to the team lead on any issues identified during research or claims review . Applies subject expertise in evaluating business operations and processes. ... Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition… more
- Centene Corporation (Jefferson City, MO)
- …medical claim review . Ensure compliance with coding practices through a comprehensive review and analysis of medical claims , medical records, claims ... Centers for Medicare and Medicaid Services. + Ensures Payment Integrity DRG Review consistently meets production standards and passes quality audits + Oversees… more
- Cardinal Health (Sacramento, CA)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Oak Orchard Health (Brockport, NY)
- …the third-party billing organization to ensure proper processing of all payer claims . This would include research for accuracy, analyze reports, follow through ... the third-party billing company + Manage Accounts Receivable related to all claims and ensure reconciliation with the general ledger. This involves working closely… more
- Insight Global (Cincinnati, OH)
- …and design studies to support product claims , and ensure all product claims comply with global regulations. Candidate will review product artwork to ensure ... to consumer data focus groups to gather insights. The specialist will also conduct update meetings to ensure team...to ensure team alignment and write defensives about product claims . Preferred candidates will have the ability to assess… more
- City of New York (New York, NY)
- …requests from MCO to obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in billing software to ... Billing by working alongside a team of talented health insurance billing specialist , you will perform health insurance billing activities and support functions… more
- University of Washington (Seattle, WA)
- …+ Coordinate claims issues with Risk Management and participate in Quarterly Claims Review meetings + Ensure vessels are operated in compliance with all ... of Naval Research (ONR) proposals with assistance from the Program Operations Specialist + Provide fiscal oversight to ensure expenditures are within established… more
- Molina Healthcare (Ann Arbor, MI)
- …post pay claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... and medical records to document relevant findings of a post pay clinical review . This position manages documents and prioritizes case load to ensure timely turn… more