- Point32Health (Canton, MA)
- …**Job Summary** The Director of Configuration and Operations of the claim adjudication systems. drives configuration strategy and execution, ensuring accurate setup ... of claims adjudication, products, benefits, payment processes and automation of...+ Paid time off + Employer-paid life and disability insurance with additional buy-up coverage options + Tuition program… more
- CareFirst (Baltimore, MD)
- …procedures, including experience with providers, training, customer service, and claims processing. **Preferred Qualifications:** + Bachelor's Degree in business, ... special pricing, medical terminology, CPT coding and CMS-1500 or CMS UB-04 claim formats. + Thorough knowledge of managed care industry legislated and regulated… more
- Covenant Health Inc. (Knoxville, TN)
- …Registration and Business Office personnel to resolve issues related to claims , coding, pre-cert, and denials appeals, and verifies that appropriate chargemaster ... in response to regulatory changes and identified areas of deficiency. + Monitors claim rejections and systematically assesses specific types of denial as it relates… more
- Elevance Health (Lake Mary, FL)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... create predictive impact decision making tools + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results post-implementation… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary + Works hospital claims to assure timely billing and appropriate reimbursement from Non-Governmental Insurance Companies. Primary Position ... tools, software and reports provided. + Perform all activities for billing, claim adjustment, account follow-up processes. + Complete payment review, working Compass… more
- Elevance Health (Lake Mary, FL)
- …organizations. **How you will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network ... practices, and specialty care procedures and recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results post-implementation… more
- Robert Half Accountemps (Seattle, WA)
- …purposes. * Identify invalid or non-compliant vendor charges and process chargeback claims with vendors. * Collaborate with publishers and internal teams to research ... and resolve claim -related issues. Requirements * Proven experience in accounts payable,...professionals, including medical, vision, dental, and life and disability insurance . Hired contract/temporary professionals are also eligible to enroll… more
- Lactalis American Group Inc. (Londonderry, NH)
- …all business OS&D and compliance incidents, manage documentation required for logistics claims and deduction refutations, and determine root causes in a timely ... systems. + Provide proper documentation to the business logistics team for claim management with carriers and third-party logistics providers (3PLs). + Serve as… more
- Elevance Health (Mason, OH)
- …organizations. **How you will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network ... practices, and specialty care procedures. + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results post-implementation… more
- Huron Consulting Group (Chicago, IL)
- …during audits are corrected as appropriate, and corrective action is initiated before the claim is rebilled to the insurance . + Conduct analysis and present ... Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims , denial and appeals issues affecting reimbursement. + Identifies, and attempts… more