- The County of Los Angeles (Los Angeles, CA)
- …new or revised procedures. + Works with Professional Standards Review Organization representative to orient new staff to Federal laws and regulations pertaining to ... provided to patients are appropriate and covered by the insurance payer. They are responsible for ensuring that patient...steps to view correspondence, and we will not consider claims for missing notices to be a valid reason… more
- Mass Markets (Wichita, KS)
- POSITION OVERVIEW CUSTOMER SERVICE REPRESENTATIVE SUPPORTING COMMERCIAL AND PUBLIC SECTOR CLIENTS We are looking for Customer Service Representatives to support ... constantly learn on the job. POSITION RESPONSIBILITIES WHAT DOES A CUSTOMER SERVICE REPRESENTATIVE DO EVERY DAY? In this role, you will be responsible for handling… more
- Mass Markets (Killeen, TX)
- …our members, employees, and communities with excellence. As a Customer Service Representative , you will engage directly with banking customers to provide product and ... your future with retirement savings programs, where available. + Disability Insurance :Short-term disability coverage is available to help protect you during… more
- Point32Health (FL)
- …+ Required (minimum): 2-4 years' experience as a customer service or member services representative in health care or insurance + Preferred: 2 years' Appeals and ... works collaboratively with the member and/or the member's authorized representative and must demonstrate superior customer service and benefit interpretation… more
- Southland Holdings (Denver, CO)
- …Develop and maintain a working relationship with the owner or the owner's representative + Read, understand, and plan according to the work specifications and ... as customer liaison + Manages change orders, budget schedule, claims , safety, staff, etc. + Has overall responsibility for...programs. Physical Demands The physical demands described here are representative of those that must be met by an… more
- Sharp HealthCare (San Diego, CA)
- …issued under the direction of the appropriate Medical Group Physician Representative .Identifies patients going into custodial level of care and appropriately ... Group Appeals on members with SNF services under appeals process.Reviews SNF claims for medical necessity and appropriateness when any information on the claim… more
- Globus Medical, Inc. (Audubon, PA)
- …leave of absence and return-to-work processes with employees, managers, and insurance vendors. + Administer Short-term/Long-term Disability and Family and Medical ... Leave Act (FMLA) claims , including tracking and...**Physical Demands** **:** The physical demands listed here are representative of those that must be met by and… more
- Highmark Health (Denver, CO)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a… more
- Queen's Health System (Honolulu, HI)
- …implementing process changes, to minimize and/or prevent denials. * Follows up on insurance claims with outstanding balances; leads meetings with payors to ... Four (4) years recent progressively responsible experience as a Patient Accounts Representative in an acute care facility, demonstrating good working knowledge of… more
- UIC Government Services and the Bowhead Family of Companies (Letterkenny Army Depo, PA)
- …a team WORK ENVIRONMENT: The work environment characteristics described here are representative of the minimum standards an employee encounters while performing the ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more