- CDPHP (Latham, NY)
- …incumbent will work closely with all departments such as Member Services, Claims Operations, Provider Relations, Health Care Network Strategy, Configuration and ... diploma or GED required. + Minimum of one (1) year experience in health care claims review and adjudication to payment/denial utilizing CPT-4, ICD 10 and HCPCS… more
- Prime Healthcare (Victorville, CA)
- …- Qualifications Education and Work Experience + 2-3 years relevant experience in health care claims and customer service. + Knowledge of Medical Terminology, ... Reimbursement + Many more Voluntary Benefit Options! (https://www.primehealthcare.com/careers/benefits/) Responsibilities Claims Examiner processes routine and non-routine claims … more
- Healthfirst (NY)
- …or GED equivalent + Direct experience working with managed care operations and/or health plans + Claims experience including root-cause analysis, system set-up, ... not limited to new product implementation, regulatory initiatives, and other various health plan business objectives + **_Serving as an advocate for Hospital… more
- CHS (Clearwater, FL)
- **Overview** ** Health Insurance Medical Claims Examiner** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims ... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and Responsibilities:** + Reviews and… more
- University of Washington (Seattle, WA)
- …Prepare and submit pre-authorization questionnaires to Qualis or ProviderOne for any Health Care Authority claims requiring pre-authorization. + Process all ... Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is responsible for… more
- Humana (San Juan, PR)
- **Become a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty ... claims , submitted either via paper or electronically. The ...Us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... (ERM). Actual results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits** **Qualifications** **Qualifications… more
- Humana (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations ... that involve customer contact, investigation, and resolution of claims or claims -related financial issues. The position...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
- Mount Sinai Health System (New York, NY)
- …**Qualifications** + Associates Degree preferred + 5 years experience in medical billing or health claims , with experience in IDX billing systems in a health ... Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with… more
- LA Care Health Plan (Los Angeles, CA)
- …auditing procedures under minimal supervision during the audits of PPGs, hospitals and health plans. Conducts sub-delegation claims oversight audits of the PPGs, ... Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location:...(Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by… more