- USAA (New York, NY)
- …and appraise low complexity (drivable, material loss, auto physical damage) auto claims in accordance with the terms and conditions of the contract, corporate ... when appropriate. + Maintains accurate and current claim file documentation throughout the claims process for low complexity claims . + Explains coverage, assists… more
- Hartford HealthCare (Farmington, CT)
- …Up/Denials Supervisor, in the day-to-day operations of the AR Follow Up & Denials Specialist Level 1, Level 2 and Level 3. Daily Operations consist of monitoring ... timely and accurate collection of third-party payers, resolving outstanding insurance claims across all Hartford HealthCare hospitals, medical group and homecare.… more
- Molina Healthcare (Seattle, WA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems ... providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI… more
- ENFRA (Montgomery, AL)
- …are the pillars of our continued success. **Overview** The Quality Control Specialist I contributes to the overall success of the organization by ensuring ... outcomes of quality control activities within the project. + Review of Project Documents: This individual will review...plans, and specifications.). + Ability to act as a specialist in quality control, keeping up with changes in… more
- AdventHealth (Tampa, FL)
- …for receiving and addressing accounts within 72 hours of being routed to the claims edit work queue and coding review needed work queue. Qualifications **T** ... billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight...education. **The val** **ue you'll bring to the team:** Review and analyze claim denials to perform the appropriate… more
- Molina Healthcare (Salt Lake City, UT)
- …care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports (LTSS), or ... likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge… more
- WSP USA (New York, NY)
- …negotiate with contractors and commit the SCA's resources on such change orders + Review contractors claims or disputed work and advise senior management as to ... Participate in the development and issuance of project procedures and policies; review and make recommendations on SCA-wide procedures and policies. + Provide… more
- University of Rochester (Rochester, NY)
- …Reviews and responds to Settlement Offers on collection agency accounts Review incoming correspondence from both internal and external customers regarding ... Presumptive financial assistance + Other recommendations to resolve account Review and resolve credit balances related to self pay...to: + Self Pay Work queues + Unbilled Cash Claims + Self Pay plans not final billed +… more
- Middlesex Water Company (Iselin, NJ)
- …submit medical files for new hires and employee benefit changes to the HR Specialist . * Administer New Jersey Workers' Compensation claims and maintain OSHA ... accurately to carrier systems. * Collaborate with the HR Specialist to verify the accuracy of benefits and beneficiary...employee must have the ability to visually inspect and review hard copy and electronic documents. Specific vision abilities… more
- The County of Los Angeles (Los Angeles, CA)
- …class receive administrative and technical supervision from a Chief Environmental Health Specialist and may receive lead supervision from an Environmental Health ... Specialist . These positions perform one of the following assignments:...establishments, verify appropriate licenses and permits, as well as review the routine complaint investigations. They issue orders to… more