- Baylor Scott & White Health (College Station, TX)
- …+ When adverse events harm patients, the CRM, led by the Corporate Director of Risk Management, investigates to evaluate patient harm. If organizational risk is ... found, the Corporate claims manager will review the event further. The CRM...incidents. Works to resolve issues before they become liability claims . + Receives information from team members who manage… more
- Trinity Health (Westchester, IL)
- …Case Management, and Managed Care to gather necessary information and ensure claims are processed efficiently. **Key Responsibilities:** + Proactively follow up on ... claim rejections and denials, make corrections, and take appropriate actions or refer claims to the necessary team for resolution. + Evaluate accounts and resubmit … more
- US Tech Solutions (Columbia, SC)
- …program interventions. **Responsibilities:** + Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, ... determinations. Identifies and makes referrals to appropriate staff (Medical Director , Case Manager, Preventive Services, Subrogation, Quality of Care Referrals,… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …+ Complete claim denial management functions to ensure timely follow-up with denied claims and complete root causes analysis to determine ways to prevent claims ... denying. + Process balance transfers, adjustment requests, refunds and corrected claims as part of accounts receivable management responsibilities. + Complete… more
- AmeriHealth Caritas (Philadelphia, PA)
- …tasks for coordination of member and/or provider appeals, the analysis of claims and appeals, and the review of medical management authorizations.; + Research ... making or example, internal committee/panel, independent review organization, internal medical director - as process dictates + Provide support presenting cases and… more
- Community Health Systems (Franklin, TN)
- …The Denial Coordinator is responsible for reviewing, tracking, and resolving denied claims , ensuring that appropriate appeals are submitted, and working closely with ... in the denials management process, supporting efforts to improve claims resolution, reduce future denials, and ensure compliance with...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
- Goodwill of the Finger Lakes (Rochester, NY)
- SUMMARY: Collaborating closely with the Director of Vision Services and providers within the department, the Occupational Therapist (OT) provides comprehensive ... assessments and progress notes that will substantiate associated insurance claims . + Provide Oversight on Medical Billing for OT...Oversight on Medical Billing for OT and Resolve Rejected Claims - 5% + Through EMR system, respond to… more
- Southland Industries (Carrollton, TX)
- …Set-up and maintain w/c claim filing system. + Assist with case management of open claims through to closure; notify safety director of safety manager of status ... Brandt's/Southland safety department, with heavy emphasis on workers compensation claims management. **Position Details** + Provide administrative support to group… more
- WM (Reserve, LA)
- …compliance. Also responsible for local coordination and management of claims -related activities, including working closely with third party administrators (TPA) ... and management to resolve claims at the least possible cost and effectively deploy post loss reduction techniques such as return to work activities. **Key Job… more
- Zurich NA (Queens County, NY)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... including an Associate Degree and 8 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft Office OR AVP, Middle… more