- Elevance Health (Cincinnati, OH)
- …Provider selection logic; Provider setup configuration and roster loading/automation, claims system knowledge; external claim (EX) reviews/fixes; provider data ... collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness… more
- Elevance Health (WI)
- …corrective action plan implementation and monitoring education and non-routine claim issues. + May coordinate Provider Manual updates/maintenance. + Identifies ... + Travels to worksite and other locations as necessary. + Experience with Claims preferred. + Experience with Microsoft Excel preferred. Please be advised that… more
- Elevance Health (IN)
- …appropriate referrals. **How you will make an impact:** + Conducts medical review/ claim review of beneficiary health records specific to therapy services in support ... in accordance with regulations and requirements. + Codes and prices complex claims using ICD-9, HCPCS and CPT manuals and coding guidelines when necessary… more
- Elevance Health (Topeka, KS)
- …corrective action plan implementation and monitoring education and non-routine claim issues + May coordinate Provider Manual updates/maintenance + Identifies ... Qualifications:** + Travel to worksite and other locations as necessary + Claims experience is strongly preferred + Kansas Medicaid regulatory knowledge strongly… more
- Katmai (Portsmouth, VA)
- …and make required updates to ensure booking to proper Primary Care Manager (PCM). + Contact patients to schedule, reschedule, and/or cancel appointments. Promote ... closure. + Capture the CLR as soon as a claim is discovered or requested by the referring provider....or requested by the referring provider. + Check applicable claims database(s), when CLRs are undocumented in-patient records and… more
- The County of Los Angeles (Los Angeles, CA)
- …recommendations on special, complicated, or problem cases. Confers with program manager concerning human resources and work problems. Assists in planning, ... color; ethnicity; religious creed; protected family or medical leave status; disability ; marital status; medical condition; genetic information; military and veteran… more
- MDD Forensic Accountants (Cherry Hill, NJ)
- …corporations, government entities, and individuals calculate the true economic damage of claims or disputes. MDD is looking for a Senior Accountant to serve ... source documents pertinent to engagement + Analyze and reconcile claim to final calculation + Prepare preliminary draft of...federal laws + Research and other tasks assigned by manager Qualifications + Bachelor's degree in Accounting + Minimum… more
- Zurich NA (Jefferson City, MO)
- …will be filled at either the Mid-Senior or Senior Level. The hiring manager will determine the appropriate level based upon the selected applicant's experience and ... and guidance to junior underwriters and other team members. + Collaborate with the claims and legal teams to ensure effective handling of claims and policy… more
- CVS Health (Bloomington, IL)
- …Schedule is Monday-Friday, standard business hours, 8:00am-4:30pm CST. Analyst Case Manager is responsible for telephonically and/or face to face assessing, ... including co-morbid and multiple diagnoses that impact functionality. - Reviews prior claims to address potential impact on current case management and eligibility.… more
- Kemper (Henderson, NV)
- …schedule adherence goals are met. Plans for future staffing needs as claim volume grows. Recommend hiring, promotions, salary adjustments, and termination of ... comply with departmental objectives. + Keeps abreast of current Company policy, claims developments and procedural changes and informs subordinates as necessary. +… more