- Molina Healthcare (Warren, MI)
- …to providers. **Job Duties** + Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, ... documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by applying advanced clinical… more
- Ventura County (Ventura, CA)
- Medical Billing Specialist II - Patient Financial Services Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4940099) Apply Medical Billing ... general direction, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal,… more
- Molina Healthcare (Long Beach, CA)
- …standards. **Knowledge/Skills/Abilities** * Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously ... years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review. **Required License, Certification, Association** Active,… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …collaborates with practice, providers, and other departmental leaders to provide education on medical coding and documentation based on audit findings and as ... Party Payors) + Collaborate with appropriate teams to ensure claims data is transferred through the clearinghouse appropriately +...on a year-for-year basis + Minimum 2 years ofrelevant audit experience in physician or facility medical … more
- Elevance Health (Tampa, FL)
- … chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, ... coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …and provider billing investigation. This role requires a deep understanding of medical claims adjudication, coding compliance, and regulatory guidelines. You ... regulatory standards. + Conduct detailed reviews of itemized bills, medical records, and other claims data to...+ Evaluate and quantify claim payment impacts associated with audit findings. + Collaborate with cross-functional teams to address… more
- Ventura County (Ventura, CA)
- Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply Medical Billing ... (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal,… more
- Festival Foods (WI)
- …settling motions, pretrial filings and conferences. + Oversee and review vocational reports and medical record reports related to various claims lines. + Act as ... to meet department objectives. Provides direct leadership to the Senior Claims Specialist and Workplace Safety Specialist. Prepares and delivers direct reports'… more
- Community Health Systems (Birmingham, AL)
- …identify trends and implement corrective actions. + Monitors and works vendor/payer audit trails, submitting secondary claims and addressing discrepancies as ... and standards. **Qualifications** + 2-4 years of experience in medical billing, insurance claims processing, or revenue cycle management required + 1-3 years… more
- Hart Medical Equipment (Grand Blanc, MI)
- …orders respecting Hart policies and insurance guidelines. Ensures the Certificate of Medical Necessity is completed to release claims . ESSENTIAL DUTIES AND ... Hart Medical Equipment provides a full range of home...+ Implement changes as requested that affect A/R and audit compliance. + Other duties as requested by Management.… more