- BrightSpring Health Services (Englewood, CO)
- …basis; perform Quality Assurance to ensure accurate and timely creation of new claims and generic invoices; ensure submitted claims meet payer guidelines. + ... changes to reduce rejections of submitted electronic and paper claims . + Work "resolved" unbilled tickets within 24 hours...A minimum of 3 to 4 years experience in medical billing with a working knowledge of managed care,… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... + Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...for processing + Perform other tasks as assigned. + Follow all applicable government regulations, including HIPAA + Comply… more
- Insight Global (Stoughton, MA)
- …perform adjudication on test claims and prepare action plans for follow -up. * Effectively communicate across databases, electronic medical records and emails ... to patients by navigating a variety of pharmacy dispensing systems to adjudicate claims , refill medications, and increase adherence in patients. Below are the key… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …JOB REQUIREMENTS + Education + High school graduate is required. Completion of medical terminology and coding classes in ICD-9-CM. + Experience + Requires minimum of ... two years in ICD-9-CM coding experience. Previous healthcare billing and follow -up experience preferred. Able to work under deadline pressure. Ability to interact… more
- Houston Methodist (Houston, TX)
- …goals. **FINANCE ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients. This ... to payors. + Creates and submits appeals when necessary. Engages the coding follow -up team for any medical necessity or coding related appeals.… more
- Robert Half Finance & Accounting (North Andover, MA)
- …who enjoy a dynamic, collaborative work environment. Responsibilities: * Process and submit medical claims to insurance providers with precision and attention to ... service by addressing patient and insurance inquiries regarding billing. * Conduct follow -ups on unpaid claims to facilitate proper payment collection. If… more
- US Tech Solutions (Columbia, SC)
- …day would like in this role: Telephonic outreach to members for various reasons: Follow -up calls to members after an ER visit and/or hospital stay. Educating members ... available to assist each other. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying… more
- Catholic Health Initiatives (Chattanooga, TN)
- …The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition Category (HCC) Quality program was developed ... by CMS to promote quality care for Medical Advantage members. By focusing on comprehensive documentation to...other portion of time focused on provider communication, and claims denial resolutions. Communicates denial trends to leadership and… more
- Elevance Health (Atlanta, GA)
- …+ Serves as a resource for complex issues and interpretation of claims , provider contracts and data, eligibility, member contracts, benefits, clinical decisions, ... and incentive bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits, 401(k) +match,… more
- Rush University Medical Center (Oak Park, IL)
- …care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or ... in a multi-tasking complex, fast paced and challenging department. * Ability to follow oral and written instructions and established procedures * Ability to function… more