- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and maximum payer reimbursement. They prioritize ... customer trust and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims to determine… more
- Donegal Insurance Group (Marietta, PA)
- …along the Susquehanna River in beautiful Lancaster County, Pennsylvania our claims operations offer a great career and development opportunity, an engaging ... team dynamic and office environment. We offer state of the art claims handling technology and continue to invest in innovative approaches to claims handling. The… more
- Independent Health (Buffalo, NY)
- …primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections. **Qualifications** + High school diploma or GED ... Rx Operations & Compliance department. + Experience working with online claims processing system preferred. + Effective oral and written communication skills… more
- BJC HealthCare (Belleville, IL)
- …to assist with physican billing follow up. Duties for this role include working claims , contacting payors, and filing appeals in hopes to get payment on claims ... + Completes accounts receivable insurance collections and follow-up on claims to expedite payment from assigned insurance companies. +...first day of the month after hire date + Disability insurance* paid for by BJC + Annual 4%… more
- PeaceHealth (Vancouver, WA)
- …Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement ... of the position** + Resolves insurance claim rejections/denials, and non-payment of claims by payors. + Identifies trends in billing and follow-up, in order… more
- Walmart (Bechtelsville, PA)
- …Manages facility-level training and execution of asset protection, safety, and claims and receiving procedures by reviewing the application of policies, procedures, ... training. Determines training needs. Develops and delivers training as needed. Manages claims and receiving operations by ensuring proper policies and procedures are… more
- PRGX (Nashville, TN)
- …recover overpayments . Review contracts, agreements, and supporting documentation to validate claims . Generate, document, and submit claims in accordance with ... company standards . Update and manage information in the claims management system . Communicate with vendors to provide backup documentation and resolve inquiries .… more
- Centene Corporation (Sacramento, CA)
- …makes recommendations to management after identifying, researching, and investigating possible claims overpayments and by proactively identify claims errors. ... + Identifies, researches and investigates complex requests and possible claims overpayments, underpayments, contract issues, stop losses, etc. from reports… more
- The Walsh Group (Chicago, IL)
- …issues, including but not limited to subcontractor default, bond and mechanic lien claims , project claims , and contract compliance. + Provide advice and counsel ... issues, including but not limited to subcontractor default, bond and mechanic lien claims , owner claims , contract compliance and development of claims … more
- Schlumberger (Houston, TX)
- …claim mitigation strategies. + Analyzing the basis and extent of change Tracking claims and monitoring progress through the claims resolution process. Analyzing ... Company and in accordance with the relevant contract. + Challenge and negotiate claims and variations submitted by the Contractor and provide an assessment of… more