- St. Luke's Health System (Boise, ID)
- …under the pharmacy benefits. + Facilitate resolutions to issues involving claims adjudication , member concerns, and provider communications. + Addresses ... and third-party issues such as prior authorization, step therapy, reviewing denied claims , and processing overrides. Works with an interdisciplinary team of… more
- LA Care Health Plan (Los Angeles, CA)
- …knowledge of claims coding and medical terminology. Solid understanding of standard claims processing systems and claims data analysis. Strong project ... Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position...(Mid.) - $163,492.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by… more
- Executive Office for US Attorneys and the Office of the US… (San Diego, CA)
- …investigation and prosecution of civil actions under statutes such as the False Claims Act and Controlled Substances Act. Our Civil Division represents the United ... Security Requirements: Initial appointment is conditioned upon a satisfactory preemployment adjudication . This includes fingerprint, credit and tax checks, and drug… more
- Veterans Affairs, Veterans Health Administration (Portland, OR)
- …benefits to Veterans who meet eligibility criteria. Staff review, adjudicate and authorize claims for costs incurred while traveling from their home to a VA medical ... Funds Transfer, paper check or denial of benefits reviews claims for accuracy and ensures all required documentation is...is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment… more
- Community Health Systems (Birmingham, AL)
- …II is responsible for managing complex billing functions, ensuring timely and accurate claims processing , and resolving issues related to insurance payments and ... and standards. **Qualifications** + 2-4 years of experience in medical billing, insurance claims processing , or revenue cycle management required + 1-3 years in… more
- Masonicare (Wallingford, CT)
- …established procedures. - Works with - operations to resolve - issues that impact claims processing . Brings problems and delinquent responses to the attention of ... submission, suspense resolution, claim follow up and credit balance adjudication /reporting for healthcare services provided to Medicare, Medicaid and...Manager. Process- corrections - and generate- claims for re- processing . - - Reviews denials… more
- Sedgwick (Bartlesville, OK)
- …team meetings and assigns accountability for follow-up items. + Gathers important compliance/ claims processing information to be presented at team meetings. + ... compensation claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices… more
- Saint Francis Health System (Tulsa, OK)
- …oversight to maximize cash flow, reduce accounts receivable days, and ensure effective claims adjudication . This position plays a key role in monitoring ... all aspects of patient financial services including professional and hospital claims billing, cash posting, and management of patient receivables. This role… more
- Banner Health (Phoenix, AZ)
- …acquired over one to two years of work experience in medical claims adjudication , contract interpretations, billing and coding, and medical terminology. ... Banner Staffing Services (BSS) offers Registry/Per Diem opportunities within Banner Health . Registry/Per Diem positions are utilized as needed within our facilities.… more
- TEKsystems (West Des Moines, IA)
- …a timely manner. This position requires strong decision-making ability around complex claims processing workflows and regulations that requires utilization of ... that will work mostly with clients on workers comp, health screening, etc. Previous occupational health physician... issues, repetitive errors, and payer trends to expedite claims adjudication Work accounts in assigned queues… more