- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …each opportunity. The role also includes the development and communication of market segment medical claims expense trends with the aim to provide insights that ... analytics to support the Business Segment, Trend Oversight and Medical Cost Council teams as well as BCBSMA Account...improve members health and health care quality and moderate claims trends + Design, implementation, and measurement of account… more
- Robert Half Accountemps (Holyoke, MA)
- …supporting top-quality patient and financial outcomes. Key Responsibilities: Review and process medical claims and billing statements for accuracy and compliance ... Description Are you an experienced medical billing professional seeking your next opportunity? Our...Submit claims to insurance providers, follow up on outstanding payments,… more
- The Kidney Experts, PLLC (Jackson, TN)
- …billing assistant is responsible for aiding the Billing Manager in processing medical claims , working claim denials, assessing insurance discrepancies, and ... payments. Duties and Responsibilities + Preparing and submitting billing data and medical claims to insurance companies + Ensuring each patient's medical … more
- Boston Mutual Life Insurance (Canton, MA)
- …year of business/office experience. Sr. Claim Examiner: Minimum of 2 years life/ medical claims experience required. Knowledge Requirements: + Strong business ... manner and meeting departmental quality/production standards. + Review and process claims , evaluate medical records, and request additional information when… more
- Molina Healthcare (Houston, TX)
- …least 1 year management/leadership experience. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims ... JOB DESCRIPTION Job Summary Leads and manages team responsible for claims activities including reviewing and resolving member and provider complaints, and… more
- CVS Health (Buffalo Grove, IL)
- …**Preferred Qualifications** + Experience with healthcare data sources, including pharmacy and medical claims + Familiarity with mental health and substance use ... each and every day. **Position Summary** The **Senior Clinical Pharmacist, Medical Affairs - Clinical Innovation and Regulatory Strategy** identifies opportunities… more
- Centene Corporation (New York, NY)
- …including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. + Provide regular ... to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review… more
- Robert Half Accountemps (Raeford, NC)
- …and a commitment to accuracy and efficiency. Responsibilities: * Process and submit medical claims to insurance companies with accuracy and attention to detail. ... Description We are looking for a skilled Medical Billing Specialist to join our team in...to ensure timely reimbursement. * Maintain up-to-date knowledge of medical billing codes and insurance regulations. * Collaborate with… more
- Sedgwick (Honolulu, HI)
- …as it relates to policy language and advises client of the outcome. + Handles medical claims (under P&I coverage) from beginning to end requesting medical ... Insurance Marine Investigator **PRIMARY PURPOSE** **:** To perform detailed admiralty claims investigation and analysis through examination of the loss, collection… more
- CVS Health (Hartford, CT)
- …improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims . You will be a key link in providing our ... CT 3 days per week)** **Claim Benefit Specialist** Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the… more