- Manulife (ME)
- …process all aspects of auditing, formal appeal reviews and contestable claim review. + Audit applications underwritten to ensure underwriting decisions, ... correspondence and administrative processing have been followed in accordance with established guidelines...management with book of business reviews. + Review contestable claims for potential misrepresentation during underwriting. + Maintain good… more
- HUB International (Scottsdale, AZ)
- …their accuracy. + Maintain controls on renewals to ensure timely preparation and processing . + Prepare summaries of insurance and proposals as needed for ... **HUB International** is a leading global insurance brokerage that provides a broad array of...provide critical support to our customers through account management, claims management, day-to-day client oversight, and underwriting services that… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …for leading the end to end AP function, ensuring timely and accurate processing of invoices, payments and vendor inquiries in a high volume environment. This ... a culture of continuous learning and development. . Oversee full-cycle AP processing ; invoice intake, 3-way match, approvals, exception handling, payments and vendor… more
- Intermountain Health (Boise, ID)
- …data to the clinical record. Leverages other system functionalities to expediate the claim processing for compliant and optimized hospital accounts. + Evaluates, ... II is responsible for appropriate charge capture, assigned account, claim edits and/or charge edits for an assigned service...Analysis + Healthcare Regulations + Process improvement + Health Insurance + CMS + Problem solving + Data Mining… more
- TEKsystems (Moorestown, NJ)
- …destination files to identify whether returned rejections should have resulted in claim creation + Review inbound Error Logs to ensure accurate claim ... Positive Pay files after each check run + Process refunds to carriers for claim overpayments + Update CPT and bundled code descriptions within the RBRVS system +… more
- HCA Healthcare (San Antonio, TX)
- …assigned) - Collaborate with defense legal counsel to coordinate the investigation, processing and defense of claims against the facility; records, collects, ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- Sedgwick (Tampa, FL)
- …service in medical field preferred. Workers compensation, disability and/or liability claims processing experience preferred. **Skills & Knowledge** + Knowledge ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign utilization review… more
- Centene Corporation (Frankfort, KY)
- …best practice and quality standards. + Applies a comprehensive knowledge of claims processing , provider customer service and payment knowledge to escalated ... Word, Xcelys, SalesForce, and Microsoft Access. Knowledge and understanding of managed care claims processing systems and medical claims coding preferred… more
- HCA Healthcare (Denver, CO)
- …otherwise assigned) . Work with defense legal counsel to coordinate the investigation, processing and defense of claims against the facility; records, collects, ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- Highmark Health (Pittsburgh, PA)
- …issues related to supported technology. Manage utilization review, translation of foreign claims , coordination of benefits (COB), and processing of claims ... employees. **GENERAL OVERVIEW** This job oversees, develops, and manages the end-to-end claims functions and operational inputs including but not limited to the… more
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