- General Dynamics Information Technology (Fairfax, VA)
- …Trusted Third Party activities. **Roles and Responsibilities** + Reviews and analyzes medical claims to determine accuracy, completeness and compliance with ... Verifies the accuracy of diagnosis and procedure codes in claims data, ensuring alignment with medical policies...codes in claims data, ensuring alignment with medical policies and industry coding standards. + Identify fraud,… more
- State of Montana (Helena, MT)
- …Medicaid and Healthy Montana Kids (HMK) programs. Key duties include analyzing medical claims data, evaluating provider billing practices, and ensuring ... for this Career Opportunity ** * Knowledge of Medicaid rules, medical claims processing, medical terminology and coding principles and practices.… more
- UNUM (Portland, ME)
- …Unum today! **General Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum ... US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …**Job Duties:** + Manual billing and payment application for secondary insurances, Noble Medical Billing Claims , home infusion claims , and DME ... Assist in billing and cash application of Medicaid/Medicare/DME/Home Infusion claims . Manage open accounts receivable which requires rebilling within timely… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …The Billing Specialist will be responsible for processing the full lifecycle of medical claims -from charge entry and claim submission to payment posting, denial ... rejections or denials promptly. + Prepare and submit appeals for denied claims , including documentation and provider narratives as needed. + Identify and report… more
- Idaho Division of Human Resources (Boise, ID)
- …system, making sure to comply with the relevant laws and regulations that govern medical claims and billing. . Experience interpreting and applying these laws, ... develop reports. Desirable Qualifications: . Experience reviewing and entering medical bills and third-party payment into the CVCP database...as well as drafting claims correspondence. . A comprehensive understanding of ICD-10 and… more
- WestCare Foundation (Dandridge, TN)
- …Functions: + Claim Preparation & Submission: Prepare and submit accurate and timely medical claims to insurance companies, government programs, and other payers. ... the reasons for denial, and take appropriate action to correct and resubmit claims . + Billing Audits: Perform regular audits of patient accounts to ensure accuracy… more
- City and County of San Francisco (San Francisco, CA)
- …billing, claims processing, and/or collecting healthcare service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third party ... and tracking of issues; + Performs revenue analysis related to charge errors, claims submission volume, denials and trends based on claim type and/or payer,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for accurate claims adjudication. This includes analysis of changes to medical code sets to determine impacts to and necessary changes of current policies, ... considered. * 3 years of relevant health plan or provider office medical coding/ claims and/or Business Analyst experience in a healthcare setting applicable to … more
- MyFlorida (Alachua, FL)
- …admission. Assist all accredited organizations, state, county or others in obtaining medical information necessary to support claims for benefits. Maintain ... medical center staff as required. Safeguard and protect all private medical information and claims information in accordance with appropriate regulations and… more