- Novant Health (Charlotte, NC)
- …Coordinator and play a vital role in ensuring timely, accurate care assessments and claims management for our patients. In this full-time role, you will complete and ... schedule the Minimum Data Set (MDS), coordinate insurance pre-authorizations, attend key interdisciplinary meetings, and support CMS claims audits, all while… more
- Sedgwick (Houston, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigation Consultant **PRIMARY PURPOSE** : To address and handle high end cases ... Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required.… more
- Zelis (FL)
- …clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA ... new DRG coding concepts to expand the DRG product. + Manage assigned claims and claim report, adhering to client turnaround time, and department Standard Operating… more
- Fairview Health Services (St. Paul, MN)
- …of hospital revenue cycle operations (registration, charge capture, health information management, claims , payment posting) + Ability to present to small and large ... of the following Epic applications: Resolute Professional Billing, Resolute Hospital Billing, Claims or + Ability to achieve within one year of employment… more
- Sedgwick (Dublin, OH)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Program Management Associate **PRIMARY PURPOSE** **:** To serve as a communication ... experience. Risk control experience preferred. **Skills & Knowledge** + Knowledge of claims management processes and procedures + Knowledge of risk control in an… more
- Zelis (St. Petersburg, FL)
- …DRG validation. They will be responsible for reviewing facility inpatient and outpatient claims for Health Plans and TPA's to ensure adherence to proper coding and ... billing, analyzing inpatient DRG claims based on industry standard inpatient coding guidelines, and...with providers + Experience and working knowledge of Health Insurance , Medicare guidelines and various healthcare programs + Understanding… more
- AECOM (New York, NY)
- …activities. + Identify conditions that could lead to a change orders or claims . + Review contract documents and advise regarding procedures and policy within. When ... Work together with project teams to analyze schedule impacts of additional work and potential claims . + Help to prepare and submit claims and claim responses as… more
- Modernizing Medicine (Boca Raton, FL)
- …will focus on advancing intelligent automation across the clinical and healthcare claims data lifecycle. The intern will work with cutting-edge generative AI and ... learning and generative AI models for clinical and healthcare claims data. + Apply LLM and NLP techniques to...days and healthy snacks delivered to your desk, + Insurance Coverage: Comprehensive health, accidental, and life insurance… more
- Sedgwick (Orlando, FL)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Patient Care Coordinator Are you looking for an impactful job that offers the ... confirming delivery of said goods or service. + Communicates with vendor partners, claims adjusters and nurse case managers providing updates on new referrals as… more
- Guidehouse (Minneapolis, MN)
- …this position include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity ... and associated coding modifiers. + Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system. +… more