- Molina Healthcare (Tacoma, WA)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Aveanna Healthcare (Atlanta, GA)
- …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... Requests Bridge Tickets to correct and update EMR. Works with Biller to ensure claims are refiled and/or billed to the second insurance in a timely manner.… more
- Aveanna Healthcare (Atlanta, GA)
- …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... correct and update EMR. Works with Collector to ensure claims are refiled and/or billed to the second insurance...school diploma or equivalent. Minimum six (6) month prior healthcare insurance experience. Computer literate and ability to type,… more
- AIG (Chicago, IL)
- …to manage risk. Join us as a Senior Regional Production Specialist, Lexington Healthcare to play your part in that transformation. It's an opportunity to grow ... and service a profitable book of miscellaneous medical facilities and allied healthcare business. + Utilize underwriter authority in accordance with the published… more
- Aveanna Healthcare (Minneapolis, MN)
- …Risk Management and Leave of Absence Specialists on all worker compensation claims and return to work coordination activities o Coordinate with People Services ... on all unemployment claims o Be primary point of contact for caregiver...entries for caregiver staff visits which generates billing o Audit weekly payroll reports and make timely payroll adjustments… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …Expected to partner with necessary entities in order to effectively input, audit and adjust within the adjudication platform. **Job Summary:** Perform day-to-day ... resources within and external to ProAct as needed in order to input, audit , and adjust data within the adjudication platform. **Responsibilities** + Perform benefit… more
- Genesis Healthcare (Danbury, CT)
- Overview Sub-Acute, Long-Term Care is a sector of healthcare exploding with potential and work-life balance flexibility (no weekends or on call)! AlignMed Partners ... Fee For Service Attending Physician for our Autumn Lake Healthcare at Glen Hill Center, located in Danbury, CT....within the Compliance Process, Standard/Code of Conduct, Federal False Claims Act and HIPAA. Participate in required orientation and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …BS/BA degree preferred or equivalent experience or training + Minimum of 5 years claims audit /quality assurance experience in healthcare required + Strong ... Ready to help us transform healthcare ? Bring your true colors to blue. What...reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices against… more
- Synergy Healthcare Solutions (FL)
- …per hour | Hourly | Posted 20-May-2025 (EST) | Business Office | Synergy Healthcare Services - Remote | FL, USA **Looking for qualified Traveling Business Office ... regulations and company policy. + Generate accurate and complete claims for billing systems for all payers. + Provide...claim edits and rejections. + Coordinate responses to various audit requests. + Assist new BOM's with month end… more
- Covenant Health Inc. (Knoxville, TN)
- …+ Coordinates with appropriate parties the complete/ partial payment or repayment of the claims , as described in the Audit Policy, as findings are identified ... Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and… more