- Integra Partners (Troy, MI)
- …Integra Partners from our provider/plan partners. Responsible for the review of DME claims for billing accuracy. Responsible for the investigation of root cause and ... policies and procedures of Integra Partners and our clients. + Ability to follow written and verbal directions. + Ability to meet consistent and punctual attendance… more
- Alight (IN)
- …through effective solutions and personal service. **Responsibilities** + Handling claims related to FMLA, disability (STD/LTD), parental leave, personal leave, ... of the leaves. + Managing and processing employee leave claims in compliance with federal, state, and company policies....meet or exceed KPIs. + Ensuring proper documentation and follow -ups in accordance with SOPs. + Identifying issues, process… more
- Elevance Health (San Juan, PR)
- …(word processing, spreadsheets, etc.) strongly preferred. + Familiarity with Medicare/Medicaid and claims . + Medical background (eg, hospital or dental office ... Claims Representative I **Location Hybrid 1:** This role...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- UPMC (Pittsburgh, PA)
- …needs. Responsibilities: + PB claims IT analyst. Ability to quickly diagnose claims issues, apply corrective changes and follow RFC procedures to sync ... UPMC is hiring a Systems Analyst-Senior (Epic PB Claims and Remittance) who had healthcare experience. If...years of recent experience utilizing those skills at a medical or behavioral health facility, clinics or physician groups… more
- Mass Markets (Killeen, TX)
- …technology to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, ... globally expanding, industry-leading organization. We are looking forCall Center Claims Representativesto support inbound customer service, help desk, and… more
- Medical Express Ambulance Service (Skokie, IL)
- …Responsibilities include accurate data entry, coding, medical necessity, and follow up of ambulance claims submissions. Applicants must have ambulance ... and excellent communication and computer skills. A good understanding of medical terminology and commercial insurance guidelines is necessary. Excellent salary and… more
- Elevance Health (Richmond, VA)
- **PBM Compliance Manager ( Claims Audit)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **PBM Compliance Manager ( Claims Audit)** is responsible for coordinating pharmacy compliance activities and initiatives… more
- TEKsystems (Louisville, KY)
- …SIDE of Louisville, KY Job Description - Prepare & process various insurance claims , verifies data by conferring with appropriate agencies on a daily basis. -Create ... & process electronic claims submission for various payers on a daily basis...-Reviews AR reports on a daily basis & performs follow up on delinquent accounts -Receives, investigates, & responds… more
- Johns Hopkins University (Middle River, MD)
- …Communicates with payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy denials ... junior specialists as appropriate. **Specific Duties & Responsibilities** + Uses A/R follow -up systems and reports to identify unpaid claims for… more
- Elevance Health (Norfolk, VA)
- **Manager Rating/ Claims System Analyst** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law. The **Manager Rating/ Claims System Analyst** is responsible for managing the day-to-day workload/workflow for… more