- Covenant Health Inc. (Sevierville, TN)
- …student-athletes. Schedule management for team practices, games & tournaments. Insurance claims processing for the student athlete medical care program. ... injuries and works with school officials to complete insurance claim forms for sports injuries. Serves as the coordinator...statements. + Incumbent oversees the coordination and processing of medical insurance plans through the claims process.… more
- BrightSpring Health Services (Centennial, CO)
- …requests and updates until final resolution is obtained. Responsible for correcting PBM claim audit deficiencies and resubmitting claims back to the payer as ... The PBM Payer Audit Specialist also performs quality assurance checks for all medical and PBM billing documentation before submission and notifies the RCM Ancillary… more
- Elevance Health (Indianapolis, IN)
- …and dollar volume of provider. + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical ... by law._ The **Provider Auditor** conducts on-site reviews of medical charts, medical notes, itemized bills and...presenting preliminary review results. + Verifies dollar amount on claim is correct in claims system and… more
- BrightSpring Health Services (Louisville, KY)
- …Signature Advantage Plan) is seeking a detail-oriented and technically skilled Quality Medical Coder to support our clinical operations. The Part Time Coder is ... responsible for reviewing and assigning accurate medical codes for diagnoses, procedures, and services performed by...guidelines, and federal regulations to support accurate reimbursement, reduce claim denials, and other task as needed. This role… more
- Elevance Health (Carroll, IA)
- …+ Coordinates prompt claims resolution through direct contact with providers, claims , pricing and medical management department. + Identifies and reports on ... + Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices. + May participation in… more
- Clark Construction Group, LLC (Mclean, VA)
- …with our in-house legal team and is responsible for managing Clark's claim and litigation docket, leading the Company's eDiscovery process, managing Clark's owner ... contracts. Will also assist in managing task trackers. + Provide support for claims management. + Oversee and manage all elements of the Company's eDiscovery… more
- Guidehouse (Birmingham, AL)
- …the following: + 227 Electronic Files + 835 Electronic Files + UB04's and 1500 Claim Files + Medical Record + Making outbound calls to Insurance Companies to ... payers by timely submitting all information needed to complete claims processing. The Central Denials Account Representative conducts thorough...resolve claim denials and account balances. + Performing Non-Clinical Appeals.… more
- Robert Half Accountemps (Irvine, CA)
- …by adhering to established policies and procedures. Requirements * Proficiency in medical collections processes, including appeals and claim administration. * ... Description We are looking for a skilled Medical Collections Lead to join our team in...with expertise in managing accounts receivable and resolving insurance claim issues. The ideal candidate will demonstrate strong communication… more
- J&J Family of Companies (Irvine, CA)
- …Interventions Medical Affairs team + Responsible for ensuring subordinates follow all Company guidelines related to Health, Safety and Environmental practices ... profoundly impact health for humanity. Learn more at https://www.jnj.com **Job Function:** Medical Affairs Group **Job Sub** **Function:** Medical Affairs **Job… more
- CVS Health (Sacramento, CA)
- …review a clinical determination and understand rationale for decision. Able to research claim processing logic and various systems to verify accuracy of claim ... person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as...Understands and can respond to Executive complaints and appeals. Follow up to assure Fast Track appeal is handled… more