- CDM Smith (Raleigh, NC)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more
- Zelis (St. Petersburg, FL)
- …Identify new DRG coding concepts to expand the DRG product. + Manage assigned claims and claim report, adhering to client turnaround time, and department ... clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA… more
- Trinity Health (Farmington Hills, MI)
- …of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates ... objective of maximizing reimbursement for services rendered and ensuring claims are paid or settled in a timely and...or settled in a timely and accurate manner. Researches claim rejections, make corrections, take corrective actions, and/or refer… more
- City of Jacksonville (Jacksonville, FL)
- …compensation claims that include primarily lost time, permanent total disability , and statutory presumption files. Work requires an advanced knowledge of ... claims that include primarily lost time, permanent total disability , and statutory presumption files. + Manage complex workers' compensation litigation… more
- Community Health Systems (Oro Valley, AZ)
- …Summary** The Billing Specialist I is responsible for performing insurance claim processing, billing, and follow-up to ensure timely and accurate reimbursement. ... contact for insurance companies and other payers, researching and resolving claim issues while maintaining compliance with billing regulations and organizational… more
- Commonwealth of Pennsylvania (PA)
- …If you are contacted for an interview and need accommodations due to a disability , please discuss your request for accommodations with the interviewer in advance of ... orientation, gender identity or expression, national origin, AIDS or HIV status, disability , or any other categories protected by applicable federal or state law.… more
- Commonwealth of Pennsylvania (PA)
- …If you are contacted for an interview and need accommodations due to a disability , please discuss your request for accommodations with the interviewer in advance of ... identity or expression, national origin, AIDS or HIV status, disability , or any other categories protected by applicable federal...Select the Level of Performance that best describes your claim . + A. I have professional experience related to… more
- University of Rochester (Rochester, NY)
- …to successful closure and obtain maximum revenue collection. Researches, corrects, resubmits claims , submits appeals and takes timely and routine action to resolve ... unpaid claims . Mentors and trains new or lower level staff....accounts, resulting in payment or resolution of the outstanding claim . The Specialty A/R associate will utilize MFG and/or… more
- Amentum (Washington, DC)
- …a Lead Project Manager, performing the following duties: + Oversee all aspects of Claim Review and Intake team management. + Lead efforts to recruit, retain, and ... and graphs. + Oversee the coordination of Project Supervisors to direct the Claims Review and Intake teams. + Create, format, and refine Standard Operating… more
- Blue KC (KS)
- …and external customer resource for interpretation of transplant benefits and transplant-related claim adjudication. Serves as a company expert on current and future ... network. + Ensures proper payment of pre-transplant, transplant, and post-transplant claims . Sets up transplant pre-pay review for each individual claim… more