- HTC Global Services Inc (Berlin, NH)
- …and payer processes. A typical description emphasizes collaboration with Enrollment teams, Claims and provider domains , and IT teams to translate complex healthcare ... adjudication and settlement. This includes both Medical and pharmacy claims . + Understanding of the provider domain and its...is not realized. + Perform user acceptance testing and support business during testing phase. + Be liaison between… more
- Health Care Service Corporation (Tulsa, OK)
- …medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Conducting research; preparing documentation of findings ... within 24 months of hire** **3 years experience in claims processing operations and reporting systems, including 2 years...committed to offering meaningful benefits to our employees to support their life outside of work. From health and… more
- Health Care Service Corporation (Quincy, IL)
- …Under Supervision, This Position Is Responsible For Processing Complex Claims Requiring Further Investigation, Including Coordination Of Benefits And Resolving ... Pended Claims . Required Job Qualifications: * High School diploma or...committed to offering meaningful benefits to our employees to support their life outside of work. From health and… more
- The Hartford (Hunt Valley, MD)
- …join a collaborative environment where you will have direct contact with our Claims Professionals and insureds and/or clients while working from home! If you join ... and are all driven to provide excellent customer service to our Claims Partners and insureds and/or clients. RESPONSIBILITES: -Analyze complex legal and factual… more
- WestCare Foundation (Fresno, CA)
- …issues. + Support internal and external audits, ensuring documentation and claims meet DHCS and payer compliance standards. + Maintain strict confidentiality of ... DMC-ODS, Enhanced Care Management (ECM), and Community Supports. This position ensures claims are submitted accurately and timely directly to insurance carriers and… more
- General Counsel (Washington, DC)
- …practice areas: benefits law; health care law; Court of Appeals for Veterans Claims litigation; revenue law; torts law; and loan guaranty. 2. Provides representation ... law and benefits, including loan guaranty benefits, and adjudication of veterans benefits claims . 3. Represents the Secretary and officials of the DVA in litigation… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... in FWA investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies;… more
- HUB International (Tallahassee, FL)
- …career that helps local businesses in the community + Strong community support and involvement through HUB Gives **SUMMARY:** The Employee Benefits Account Manager ... resolution with insurance companies and insureds on problems with policy services, claims or coverage concerns. + Assist advisor in insurance business, quotes, and… more
- MyFlorida (Largo, FL)
- …in medical billing (billing third-party health insurance) and processing electronic claims . + Experience in accounts receivables and collections. + Experience in ... portals and websites. The Accountant IV incumbent is responsible for performing claims processing, posting payments and collection activities of the State Veterans'… more
- Insight Global (Dallas, TX)
- …specific customer service requirement to achieve the best possible outcome in the claim - Support the goals of the Claims Department We are a company committed ... client's team. Responsibilities will include managing complex workers' compensation claims , ensuring fair and efficient resolution while maintaining compliance with… more