- University of Rochester (Rochester, NY)
- …but are not limited to, coding abstraction, pre-bill coding edits, claims resolution functions, and providing recommendations to enhance coding acuity, quality, ... assigned functional area and serving as the team's coding specialist . This role acts as a subject matter expert...and accurate manner. **20%** Uses knowledge and experience to review and trend analytic and reporting data identifying problem… more
- Beth Israel Lahey Health (Burlington, MA)
- …**Job Description:** 1. Conducts initial post-offer/pre-placement physical assessment, including review of immunization status, and provides required testing or ... 4. Assists Manager of Employee Health and Infection Control Specialist in follow up of employee exposures to blood...policy regarding program. In absence of manager, files appropriate claims reports and works as liaison with physician and… more
- CVS Health (Madison, WI)
- …Microsoft Word, Excel and other computer software **Preferred Qualifications:** * Managed care/ claims review experience preferred **Education:** * BA, BS or ... Knowledge of Aetna clinical and coding policy and experience with appeals, claim review , reimbursement issues, and coding is preferable, but a willingness to learn… more
- University of Rochester (Albany, NY)
- …and training, licensure, work history, hospital affiliation history, malpractice claims history, board certification status, criminal background, evaluation of ... and adverse information obtained during the application process to ensure review and approval bodies have information needed to make informed credentialing… more
- Elevance Health (Dearborn, MI)
- …referral and/or make referral appointment as circumstances warrant. + Review for medical appropriateness psychiatric/substance abuse cases utilizing professional ... practice that is relevant to the clinical area under review . + Provide reviews for predetermination of medical necessity....+ Conduct business in a professional manner. + Troubleshoot claims issues. + Investigate and research to resolve customer… more
- ASRC Industrial Services (Sacramento, CA)
- …Regional Corporation (ASRC), an Alaska Native Corporation (ANC) established under the Alaska Native Claims Settlement Act of 1971. As part of an ANC, EQM is a ... as a waste Transportation & Disposal Coordinator or Regulatory Specialist in support of other PMs from time to...costs vs. planned schedule and costs. + Oversee and review daily cost tracking reports and review … more
- Lowe's (Mooresville, NC)
- …may include, but are not limited to: + Support IP claims and litigation, including claim intake, investigation, coordinating litigation holds, discovery, ... facts, documents, witnesses and events to assist assigned counsel; + Gather, review , and organize relevant information for discovery and/or early case assessment and… more
- City of Chicago (Chicago, IL)
- …of reported injury on duty (IOD) incidents and recommends referrals to physician specialist (s) that would be most appropriate to treat a member with an IOD ... . Performs all case management responsibilities based upon objective and professional review of the available documentation _Additional duties may be required for… more
- Rush University Medical Center (Chicago, IL)
- …Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. ... Bachelor's Degree * Certified Professional Coder (CPC) or Certified Coding Specialist - Physician Based (CCS-P) * Registered Health Information Administrator (RHIA)… more
- MyFlorida (Largo, FL)
- …Tool (https://compcalculator.myflorida.com/) ACCOUNTANT III - HEALTH INSURANCE BILLING SPECIALIST FLORIDA DEPARTMENT OF VETERANS' AFFAIRS Agency Headquarters, Mary ... Accounts Receivable billing software systems. + Perform third party claims processing and collection activities for all payors of...any other payer for the State Veterans' Homes. + Review and monitor resident accounts ensuring that the account… more