- World Insurance Associates, LLC. (Seattle, WA)
- …collaborating with the team to resolve issues (eligibility, carrier coverage and claims issues, compliance; health care reform, HIPAA). + Lead the delivery of ... enrollment, benchmarking, financial and utilization data based on financial review standards and make recommendations as appropriate. + Support the renewal process, including marketing activities, underwriting and renewal development, and negotiating on behalf… more
- CVS Health (Lansing, MI)
- …provider demographic and contract information in appropriate systems to support claims adjudication and provider directories. + Follows area protocols, standards, ... and policies to provide effective and timely support. + Coordinates with internal/external constituents to implement new networks and complex contractual arrangements. + Communicates directly with providers and/or outside vendors to clarify data quality… more
- Clean Harbors (Norwell, MA)
- …provide mentor union awareness plans + Represent the company's interests in claims and proceedings involving union organizing drives. + Develop tools and programs ... to understand and measure employee engagement (qualitative and quantitative) + Collaborates with management and HR teams to implement systemic programs to improve employee engagement and positive retention + Conducts needs assessment, develop training… more
- Parsons Corporation (Centreville, VA)
- …files to storage. Ensures retention of hard copy of reports and claims for seven years. Serves as liaison between subcontractor and procurement personnel. ... Performs other responsibilities associated with this position as may be appropriate. Qualifications: Bachelor's Degree in Business Administration (or related field) and typically 3+ years of related work experience involving typical procurement activities,… more
- Vanderbilt University Medical Center (Nashville, TN)
- …account inquiries and payer denials. . KEY RESPONSIBILITIES * Processes claims , payments, adjustments, refunds, denials, and unpaid patient and insurance balances. ... * Accesses and corrects, if needed, demographic, insurance and financial information. * Provides accurate account maintenance and documentation. * Serves as a liaison with insurance companies, third party payors, and administrative personnel. * Analyzes… more
- World Insurance Associates, LLC. (Great Bend, KS)
- …excellent service, and professional communication + Handling renewals, service requests, claims , billing and new policies + Maintain a thorough understanding of ... the markets and their appetites, underwriting guidelines, submitting and procedures + Review all applications, policies, endorsements and audits for accuracy + Complete loss/claim analysis and summaries + Coordinate expiration list with department manager to… more
- Northwell Health (Lake Success, NY)
- …editor report to analyze, research and resolve issues related to Medicare outpatient claims that generate code editor edits. + Maintains current knowledge base of ... regulatory & coding guidelines, billing processes, Ambulatory Payment Classification (APC) groups, federal, state and regulatory agency coding and reimbursement changes and coding requirements to ensure hospital procedures and services are properly ordered and… more
- World Insurance Associates, LLC. (Syosset, NY)
- …cases + Create monthly financial reporting packages including detailed premium, claims , membership, commission, and cash reconciliation information + Create weekly, ... monthly and quarterly financial statements and/or projections + Assist in quarterly presentation to clients on financial performance of insurance programs + New Business Financial Evaluations, as needed by sales team + Provide timely, courteous and accurate… more
- Centene Corporation (Carson City, NV)
- …opportunities + Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups + ... Evaluate and monitor providers' performance standards and financial performance of contracts + Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language +… more
- University of Virginia (Charlottesville, VA)
- …the financial aspects of patient care, including billing, insurance claims , payment processing, financial counseling, utilization and revenue cycle analysis. ... These roles are responsible for managing patient entry points into the healthcare system, including scheduling, registration, and verifying insurance. Patient access staff ensure that patients can efficiently navigate administrative processes while maintaining… more