- TEKsystems (Brookfield, WI)
- …according to external contract. Performs other duties and responsibilities as assigned. Skills claims processing , claims adjudication , call center, ... established time frame is reached without resolution. Monitors computerized system for claims processing errors and make corrections and/or adjustments as… more
- Dignity Health (Bakersfield, CA)
- …role responsible for the detailed and accurate processing , review, and adjudication of complex healthcare claims . This position requires expert knowledge of ... claims processing , coding, and regulatory compliance. The Claims ...Coder (CPC) **Where You'll Work** The purpose of Dignity Health Management Services Organization (Dignity Health MSO)… more
- The Cigna Group (Bloomfield, CT)
- …role, you'll manage simple to complex claims systems configuration within the claims adjudication engine. The Claims Systems Configuration Associate will ... data integrity, data security and process optimization for EviCore claims processing . In addition, they will perform...in a computer related field, preferred** **2+ years of claims and health care data experience, required**… more
- Trinity Health (Columbus, OH)
- …+ In conjunction with the 3rd party vendor, create/maintain DLT's for claims processing staff **Minimum Qualifications** + .Education: Associate or Bachelor's ... degree preferred + .Experience: 5 years medical claims or relevant health insurance + In depth understanding of Medicare & Medicare Advantage. + Excellent… more
- TEKsystems (Milwaukee, WI)
- …+ Obtains additional information from appropriate person and/or agency as needed. Skills claims processing , claims adjudication , call center, medicaid, ... High school diploma or equivalent preferred. + 2-4 years claims processing experience required + Knowledge of...plus + Prior experience with ACA, Medicaid, or similar health plans preferred not required + Coding experience preferred… more
- CVS Health (Hartford, CT)
- …This critical role involves addressing significant challenges related to enrollment, billing, and claims processing on the Majesco LA&H Core Suite. The ideal ... on resolving high-priority defects and systemic issues impacting enrollment, billing, and claims processing + Deep-Dive Analysis & Root Cause Identification:… more
- Molina Healthcare (Albany, NY)
- …claims processing errors. **Essential Job Duties** + Audits the adjudication of claims using standard principles, and state-specific regulations to ... leadership for improvements based on audit results. + Reviews timeliness of claims processing to ensure compliance with contractual and state/federal… more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills &...(must have):** + Knowledge and experience of claim operations, health care reimbursement, public health care programs… more
- Sedgwick (Marlton, NJ)
- …NJ** **Hybrid schedule** **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Providence, RI)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more