- Highmark Health (Pittsburgh, PA)
- …specific to professional, hospital, ambulatory surgical center, home health and durable medical equipment to identify key areas of risk exposure and develop plans ... recover identified overpayments, performing a follow-up review to ensure that the claims were adjusted correctly, resulting in expected recovery/savings. + Perform … more
- City of New York (New York, NY)
- …Compensation Division are responsible for all medically related issues for medical management of workers' compensation claims . Responsibilities include: Consult ... not related to the claimant's job related injury. Assist examiner and legal staff to determine compensability of treatment...relates to the claimant's work injury and assist with medical case management of claims . Review and… more
- NTT DATA North America (Boston, MA)
- …) REMOTE EAST COAST The Investigator will be assigned to conduct pre-payment reviews of medical records for healthcare claims in one or more of the following ... Hospitalization and Intensive Outpatient Programs; (2) Laboratory Testing; and/or (3) Durable Medical Equipment. The Investigator will work under the direction of an… more
- UCLA Health (Los Angeles, CA)
- …progress, recommending medical treatment interventions to the third-party claims examiner , and ensuring compliance with applicable workers' compensation ... Compensation Analyst and department manager, you will manage workers' compensation claims by supporting employees who have experienced work-related injuries or… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …analytic problems through communication and collaboration. + Knowledge of BCBSMA claims processing system is preferred. + Proficient analytical and report ... data and identify potential fraud risks. + Working knowledge of health insurance claims coding, including CPT, HCPCS, ICD-10, and DRG coding. This is an essential… more
- Air National Guard Units (Flowood, MS)
- …Specialist in planning, controlling, conducting, and administering the operational and medical activities with direct responsibility for assigned programs, to train ... Squadron Commander and the Operations Group Commander. Incumbent insures that command medical and operational policies are applied and carried out in the day-to-day… more
- STG International (Rockville, MD)
- …hands-on component. May require ACLS training. May be required to have the Medical Examiner 's Certificate for Certified Driver License exams, Proof of annual ... Program provides critical support in evaluating and managing workers' compensation claims , reasonable accommodations, Family Medical Leave Act (FMLA) requests,… more
- Johns Hopkins University (Las Vegas, NV)
- …+ Experience in Occupational Medicine, Workers' Compensation, and DOT exams. + DOT Medical Examiner . + Certified Urine Drug Screen Collector. + Certified Breath ... The position also works closely with the Executive Director, Medical Director, and Assistant Director of the Division of...wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. +… more
- State of Colorado (Denver, CO)
- …protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries. + To hold individuals accountable for ... to civil investigations in support of the Colorado False Claims Act. Additionally, the incumbent will provide technical training,...cases from intake to completion; + Experience working with medical records and bank records during the course of… more
- Johns Hopkins University (Chicago, IL)
- …+ Experience in Occupational Medicine, Workers' Compensation, and DOT exams. + DOT Medical Examiner . + Certified Urine Drug Screen Collector. + Certified Breath ... required for lab testing provided on-site. + Maintain patient medical records. _Work collaboratively with the Benefits and Safety...wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. +… more