- Sedgwick (Columbus, OH)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor… more
- AIG (Boston, MA)
- …on the portfolio. + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ensuring mitigation ... Join us as a Claims Analyst IV to take on key responsibilities...spent at work to offer benefits focused on your health , wellbeing and financial security-as well as your professional… more
- Elevance Health (St. Louis, MO)
- …unit/brand as appropriate regarding approved interventions such as recovery of overpayment, pre-payment audit of claims or putting providers on notice. + Trains ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- Elevance Health (Richmond, VA)
- …claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. + Prepares correspondence to providers ... Alternate locations may be considered. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
- Trinity Health (Columbus, OH)
- …of initiative and complete projects according to established timelines. + Knowledge of health plan operations ( claims , revenue, or risk adjustment) preferred. + ... improvement. + Under general supervision, performs research and analysis of complex health care claims , pharmacy, and lab data regarding network utilization… more
- Travelers Insurance Company (Hunt Valley, MD)
- …this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim ... resolution for personal or business claims of moderate severity and complexity. Handles ...business other than property (ie auto, workers compensation, premium audit , underwriting) may be required. Provides quality claim handling… more
- Covenant Health Inc. (Knoxville, TN)
- …Business Office Full Time , 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with ... area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the… more
- Independent Health (Buffalo, NY)
- …include continuous review of the accounts receivable aging report and ensuring all open claims are paid in a timely fashion. The coordinator will analyze data to ... payables or business to business account servicing required. Pharmacy and pharmaceutical claims knowledge preferred. + Experience working with online claims … more
- BAYADA Home Health Care (Pennsauken, NJ)
- **BAYADA Home Health Care** is currently seeking a full-time Reimbursement Services (Operation) Senior Manager! This is a REMOTE opportunity! POSITION SUMMARY: ... accurate production of bills along with the collection of outstanding invoices and claims . Responsible for the direct supervision of staff within the assigned unit.… more
- Trinity Health (Ann Arbor, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... hospital information system(s), to ensure accurate and timely submission of claims . + Determines visit-specific co-payments and collects out-of-pocket liabilities. +… more
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