- Highmark Health (Pittsburgh, PA)
- …evaluate claim processes specific to professional, hospital, ambulatory surgical center, home health and durable medical equipment to identify key areas of risk ... recover identified overpayments, performing a follow-up review to ensure that the claims were adjusted correctly, resulting in expected recovery/savings. + Perform … more
- BAYADA Home Health Care (Pennsauken, NJ)
- BAYADA Home Health Care is seeking a Healthcare Medical Collections Associate to work in our Home Health Reimbursement Services office in our state-of-the-art ... skills. + Demonstrated record of goal achievement. + Prior health care and home care experience is a plus....denial management functions to ensure timely follow-up with denied claims and complete root causes analysis to determine ways… more
- UnityPoint Health (Urbandale, IA)
- …for specialty medications . Understands pharmacy benefit and medical benefit claims submission process for reimbursement of prescription medication s . Communicates ... of the healthcare team for patients to initiate and continue therapy. Why UnityPoint Health ? At UnityPoint Health , you matter. We're proud to be recognized as… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …party reimbursement agencies, and stays current with coding updates ensuring clean claims are submitted for adjudication. + Performs a comprehensive review of the ... trends, and identifies front end edits based on denied claims . Correct or compose appeal letters when appropriate. Works...of diagnostic and procedural codes. Knowledge of Epic Electronic Health Record in order to analyze encounters and notify… more
- CVS Health (Sacramento, CA)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...**Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as… more
- BrightSpring Health Services (Indianapolis, IN)
- …pharmacy, virtual nursing and pharmacist support, as well as coordination of health care resources such as home-based Primary Care, personal care services, home ... health and/or rehab. Whether patients are referred by a...resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) + Maintains current… more
- CVS Health (Tallahassee, FL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as billing practices, while collaborating… more
- CVS Health (Scottsdale, AZ)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...day. **Position Summary** This position is responsible for reviewing claims and PDE (Prescription Drug Event) errors. This includes… more
- CVS Health (Baton Rouge, LA)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation… more
- Baylor Scott & White Health (Plano, TX)
- **About Us** Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest ... our offerings, which may include: + Immediate eligibility for health and welfare benefits + 401 (k) savings plan...patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM… more