- Atlantic Health System (Morristown, NJ)
- …with the ability to handle a variety of matters related to claims , policy development, and professional review activities. Responsibilities + Review professional ... liability claims and...litigation experience + Management Experience Preferred #LI-AW1 At Atlantic Health System, our promise to our communities is; Anyone… more
- BrightSpring Health Services (Union City, CA)
- …performance management. We offer: DailyPay Flexible schedules Competitive pay Shift differential Health , dental, vision and life insurance benefits Company paid ... Prior supervisory experience. Skills/Knowledge: + Required: Knowledge of Medicaid claims regulations and processes. Basic understanding of drugs, medication… more
- American Water (Chattanooga, TN)
- …an American Water employee, you will be offered a competitive salary and health benefits package, along with opportunities to develop, grow, and evolve your career. ... Our benefits packages focus on key areas such as health & wellness, emotional & well-being, and savings for...product liability. * Responsible for selection and oversight of insurance company or independent counsel with regard to litigated… more
- Elevance Health (Indianapolis, IN)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Elevance Health (VA)
- …provide non-clinical review and analysis of all complex Tier I post service medical claims . **How you will make an impact:** + Utilizes guidelines and review tools ... to analyze assigned claims and medical records to either approve or summarize...$36.46. Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- Elevance Health (Mendota Heights, MN)
- …The **Excess Loss Specialist** is responsible for working independently reviewing claims and interpreting contracts. Works with complex concepts of excess loss, ... an impact :** + Assists auditors with obtaining information for stop loss claims . + Tracks payments from third-party administrators that have been funded. + Prepares… more
- Martin's Point Health Care (Portland, ME)
- …of relevant education and experience. Experience + 3+ years of experience in the health insurance field. + Proven experience and success in a mentoring role ... Join Martin's Point Health Care - an innovative, not-for-profit health...+ Demonstrates advanced knowledge of enrollment / disenrollment guidelines, claims processing and plan benefits necessary to exercise decision-making… more
- Elevance Health (Hanover, MD)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …is directly accountable for contributing to audit functions, business continuity, claims management, insurance , physical security, integrated risk management and ... every patient. And together, CHLA team members will turn health care into health transformation. Join a...trends * Senior leadership experience in healthcare, risk management, claims management, insurance and/or other relevant areas… more
- University of Rochester (Albany, NY)
- …accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage. Follows up on unpaid ... payment trends and issues. + Bills primary and secondary claims to insurance . + Identifies and clarifies...insurance adjustments or retractions. Reviews and works all insurance credits in electronic health record. Enters… more