- Centene Corporation (Tallahassee, FL)
- …to external provider related issues + Investigate, resolve and communicate provider claim issues and changes + Engage with and educate providers regarding policies ... and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform provider orientations and ongoing provider… more
- Insight Global (Garland, TX)
- …that an efficient operation is maintained. - Investigate and process all unemployment insurance claims . - Serve as company representative at hearings, as needed. ... - Administer and assure compliance of all workers' compensation claims . - Review and ensure appropriate action and make...and ensure appropriate action and make recommendations with each claim . - Establish and promote maintenance of safe and… more
- Robert Half Accountemps (Los Angeles, CA)
- …Maintain and analyze financial and operational performance metrics related to claims processing, denial management, and payment posting. + Collaborate with ... reduce denials and delays in reimbursements. + Conduct root cause analysis for claim denials and develop strategies for resolution. + Participate in budgeting and… more
- Cognizant (Austin, TX)
- …with configuration analysts and other operational stakeholders to maintain and improve claims reimbursement systems. **In this role, you will:** + Review health ... standards (CPT, CCI, CMS). + Manage and update the Claims Reimbursement database to ensure edit rules and tables...with CPT, CCI, CMS, or health plan-specific rules for claim payment. + Knowledge of health plan/provider contracting and… more
- Robert Half Accountemps (Minneapolis, MN)
- …days. * Investigate and resolve issues impacting revenue cycle performance, including claim denials and underpayments. * Ensure accurate charge capture, coding, and ... timely submission of medical claims . * Collaborate with finance and operations teams to...professionals, including medical, vision, dental, and life and disability insurance . Hired contract/temporary professionals are also eligible to enroll… more
- Actalent (Riverside, CA)
- …including forecasting, accruals, and tracking against plan. + Oversee warranty claim administration, adjudication, and timely resolution. + Monitor and manage ... corrective actions, ensuring clear communication and timely closure of claims . + Work directly with customers to guide them...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- AmeriHealth Caritas (Baton Rouge, LA)
- …These SMEs will be available to AEs when needed for support of claims resolution. + General Operational Knowledge related to provider satisfaction, education and ... communication with a fundamental understanding of operational items such as claims , payment integrity, provider data, credentialing, appeals disputes etc. +… more
- Insight Global (Woonsocket, RI)
- …Requirements Experience in healthcare or insurance , specifically any Claims Knowledge and overall understanding, including provider/member/ claim flow ... including risks and issues, to senior leadership Ability to facilitate technical and business discussions effectively RTC experience Has managed teams within claims more
- Robert Half Accountemps (Burlington, NC)
- …You will play a key role in ensuring timely payments, managing claims , and contributing to the overall efficiency of our financial operations. Responsibilities: ... related to billing inquiries and provide clear, accurate responses. * Administer claims and resolve discrepancies to maintain accurate account records. * Utilize… more
- Hackensack Meridian Health (Edison, NJ)
- …such as real time eligibility (RTE), Medicare Payer Secondary Questionnaire (MSPQ), Insurance plan codes, proper sequencing of COB (Coordination of Benefits), and ... to provide education, increase the overall number of clean claims , and decrease the rework necessary to generate clean...with understanding and applying logic to registration errors and claim rejections. + Experience with EPIC. + Prior experience… more