- UNC Health Care (Smithfield, NC)
- …issues with Research Accounts to ensure proper billing. 10. Other: Responsible for processing Part B split claims . Accurately and thoroughly document the ... variety of complex duties in support of reimbursement from patient and insurance carriers throughout the revenue cycle from pre-service with prior authorizations and… more
- Advanced Orthopedics and Sports Medicine Institute (Freehold, NJ)
- …or group. All account must be documented with current status and strategy to bring claim to closure. Compile claims data and update logs, tracking and trending ... the AOSMI and takes appropriate action to recover overdue payments and litigated claims to ensure timely and efficient resolutionBenefits * Medical insurance *… more
- Robert Half Accountemps (Sacramento, CA)
- …plans * Exhibit strong skills in writing appeals and effectively work with insurance companies to resolve denied or underpaid claims * Comfortably communicate ... to permanent employment option. Responsibilities: * Ensure accurate and efficient processing of medical collections * Uphold comprehensive records relating to… more
- City of Bozeman (Bozeman, MT)
- …to determine causes of action and to prepare cases accordingly; + Assists with processing liability claims filed against and by the City, including gathering ... information, preparing claim forms, transmitting information to insurance companies, and tracking claim status; + Provides support for the City's Victim… more
- TEKsystems (Grand Rapids, MI)
- …modem to company-provided phone. Preferred Qualifications + Experience in logistics, dispatching, or claims processing . + Associate degree or higher. Job Type & ... customers and technicians. + Provide accurate information, complete forms, and determine claim status based on guidelines. + Dispatch and schedule service requests… more
- The Cigna Group (Morris Plains, NJ)
- …NCPDP guidelines; Point of Sale; Coordination of Benefit ("COB"); manual submitted claims processing ; retail pharmacy network system; CA-7 Scheduler; Endeavor; ... with or knowledge of: IBM Mainframes; COBOL6; JCL; VSAM; DB2; MQ; TSO/ISPF; PBM claim adjudication processing ; Inflation Reduction Act ("IRA"); CMS (HIPPA);… more
- GuideOne Insurance (West Des Moines, IA)
- …and analytics ecosystem by embedding AI and Generative AI capabilities across Policy, Claims , Billing, and Administrative systems. As the AI Lead Engineer - AWS ... will play a key role in supporting The Mutual Group (TMG), GuideOne Insurance , and future members by architecting, designing, and leading the delivery of end-to-end… more
- Fallon Health (Worcester, MA)
- …we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for ... as the initial investigator for provider appeals related to filing limit, claim denials, claim payment, retrospective referrals, administrative inpatient days… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …including but not limited to Epic, Microsoft Word, Excel, Email and electronic data processing skills + Working knowledge of insurance rules and regulations + ... systems as well as in depth advanced knowledge of medical billing and insurance rules and regulations to resolve accounts receivables issues. This position serves as… more
- Humana (San Juan, PR)
- …outcomes. **Key Responsibilities:** + Lead large-scale product efforts focused on improving claims processing and related systems, ensuring these efforts support ... SAFe framework, with special attention to privacy, security, and regulatory requirements in claims processing . + Act as an escalation point for critical delivery… more