- Fresenius Medical Center (Pittsburg, CA)
- …or other situations change. + Completes and follows up with paperwork when claims are disputed for non-payment. + Collects necessary documents to completed initial ... work progress on caseloads; Analyzes patient reports from billing systems as an audit check to ensure the correct insurance information is entered into the billing… more
- WellSpan Health (York, PA)
- …qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. Evaluates ... and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status. Develops and… more
- Covenant Health Inc. (Knoxville, TN)
- …reports every morning. + Follows up on identified deficiencies related to the billing claims audit within 24 hours following receipt of the Billing Claims ... approves all orders for tracking purposes and route to Medical Records to be sent for physician signature. Ensures...Follows up on identified deficiencies related to the billing claims audit within 24 hours following receipt… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- Sedgwick (Fort Worth, TX)
- …& Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care; transfers payment allocations; and runs manual pre-pay… more
- Insight Global (Pleasanton, CA)
- …for outpatient mental health. * Ensure provider documentation supports all billed services. * Audit claims to minimize risk of denials or audits. * Investigate ... responsible for the accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role ensures compliance with… more
- The County of Los Angeles (Los Angeles, CA)
- …operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors. + ... Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance sheets,… more
- Martin's Point Health Care (Portland, ME)
- …+ Demonstrates advanced knowledge of enrollment / disenrollment guidelines, claims processing and plan benefits necessary to exercise decision-making authority ... to reprocess claims in accordance and alignment with regulatory and internal...of current appeals related regulations, best practices, and common audit findings. + Participant in process improvement opportunities to… more
- Blue KC (Kansas City, MO)
- …findings and recommendations. Present reports to key stakeholders (eg, Provider Relations, Medical Management, Pharmacy, Claims , Legal) + Assist in coordinating ... of our offerings include:** **Highly competitive total rewards package, including comprehensive medical , dental and vision benefits as well as a 401(k) plan that… more
- Northwest Florida Community Hospital (Chipley, FL)
- …(NFCH), in Chipley, FL, is seeking a FT experienced, energetic and dedicated Medical Business Office Manager to provide exceptional care for our patients in support ... with medical Providers and staff, in our Patient Financial Services...good understanding of how government payers adjudicate and process claims . A solid understanding of the various payment methodologies… more