- State of Minnesota (St. Paul, MN)
- …will be considered for this position.** One (1) year* of experience processing claims and/or appeals. *Associate's degree in Business Administration, Public ... due to a qualifying condition, such as a severe health condition that prevents them from working, or when...+ Knowledge of standard operating procedures for reviewing and processing claims . + Knowledge of data protection… more
- NTT America, Inc. (Plano, TX)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a ** Claims Processing Associate** to join our team for a remote position. **Role ... methodology/ fee schedule **Required Skills/Experience** + 1+ years hands-on experience in Healthcare Claims Processing + 2+ years using a computer with Windows… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Pathway from BRCC, can be used in lieu of the one year of experience. + Claims processing or claims coding experience is preferred **Skills and Abilities** + ... claims information to ensure the accurate and timely processing of claims . Enters all information needed...and problem solving skills + Familiarity with medical and health insurance terminology preferred + Demonstrated verbal and written… more
- Robert Half Office Team (Ontario, CA)
- …priority, appeal status, scanning need, and health plan risk. + Ensure all claims received are complete and ready for processing . + Route unclean claims ... Ontario, California. This long-term contract position involves supporting the claims processing team by ensuring accurate intake,... back to providers for correction. + Forward out-of-state claims to the appropriate health plan for… more
- Centene Corporation (Harrisburg, PA)
- …the subject matter expert for other Claims Liaisons. + Analyze trends in claims processing issues and identify work process solutions + Lead meetings with ... for our 28 million members. Centene is transforming the health of our communities, one person at a time....configuration related work process changes + Analyze trends in claims processing issues and assist in identifying… more
- Providence (OR)
- …or legal handling of claims issues. + 5 years Relevant general claims processing or management experience or an equivalent combination of direct legal ... Management (CPHRM) * 2 years of healthcare professional liability (medical malpractice) claims processing or management experience * Insurance Carrier Experience… more
- CVS Health (Blue Bell, PA)
- …leading modernization efforts. + Strong understanding of regulatory compliance in claims processing . + Excellent communication and stakeholder management skills. ... At CVS Health , we're building a world of health...modernization of legacy systems-primarily IBM Mainframe platforms-used for commercial claims routing, adjudication, and operational reporting. This role ensures… more
- Amrize (Nashville, TN)
- …budget goals. + Provides guidance to Junior Warranty Claims Investigator regarding claims analysis and processing . **WHAT WE ARE LOOKING FOR** + 6+ years ... Warranty Claims Investigator Requisition ID: 14651 Location: Nashville, TN,...a repair contractor, ordering/shipping materials, reviewing work completed and processing contractor invoices. This Investigator position is for our… more
- Integra Partners (Troy, MI)
- …is responsible for leading complex projects and initiatives related to claims adjudication, processing , compliance, and operational improvements. This role ... requires deep subject matter expertise in healthcare claims systems, workflows, and regulatory requirements. The PM will collaborate with cross-functional teams to… more
- Commonwealth Care Alliance (Boston, MA)
- …Revenue Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** ... (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment methodologies +… more