- University of Rochester (Rochester, NY)
- …Documents all account follow up activity. + Research and calculate under or overpaid claims ; determine final resolution + Review and determine correct follow up. ... Elmgrove Rd, Rochester, New York, United States of America, 14624 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department:… more
- Festival Foods (WI)
- …and plans to meet department objectives. Provides direct leadership to the Senior Claims Specialist and Workplace Safety Specialist . Prepares and delivers ... available programs related to various lines of insurance are fully utilized. + Review company policies and emerging trends within claims to determine coverage… more
- Scot Forge Company (Spring Grove, IL)
- …requirements; ESOP working knowledge + Review , examine, investigate, and analyze worker 's compensation claims , inform management, third party claims ... maintain relationships with all departments to best service them in handling of worker 's compensation claims and other related matters. This role will develop,… more
- ICW Group (Sacramento, CA)
- …adherence to the daily and scheduled focused audit plan. + Conducts regular, ongoing review and analysis of all Claims Auditors to ensure audit quality and ... and workflows for Audit & Compliance program. + Works closely with training specialist and claims management staff to correct deficiencies and address technical… more
- University of Southern California (Alhambra, CA)
- The Collector Appeal Specialist is responsible for accurately processing inpatient and out-patient claims to third party payers and private pays, following all ... guidelines are met; provided quality control checks on paper and electronic claims ; process tracers, denial and related correspondence; initiate appeals; compose and… more
- 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
- Horizon Services, Inc. (Hayward, CA)
- …information. + Assist employees with health, dental, life and other related benefit claims . + Coordinate workers ' compensation claims with third-party ... executive team. + Collaborates with Learning and Staff Development Specialist to train managers on writing job descriptions, conducting...per our protocols and reports on this periodically. + Review , improve and update on an ongoing basis the… more
- University of Southern California (Alhambra, CA)
- …& systems such as PBAR and nThrive/MedAssets/XClaim in a manner to assure claims drop timely with appropriate codes. Performs other coding department related duties ... abstracted UB-04 & OSHPD data elements prior to billing interface and claims submission. + Works cooperatively with HIM Coding Support and/or Clinical Documentation… more
- Chenega Corporation (Rockville, MD)
- …compensation programs, or managed care. + Professional Background: Relevant experience in claims review , healthcare administration, or related fields. + A ... program knowledge, leadership, and/or support experience. + Must have experience in claims review , healthcare administration, or related fields. + Must have… more
- Rochester Regional Health (Rochester, NY)
- … Review : Conduct detailed reviews of denied or underpaid claims , prepare appeal letters, gather supporting documentation, and collaborate across departments ... Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims … more