- NTT DATA North America (MO)
- …methodology/ fee schedule/ **Required Skills for this role include:** + 2+ year(s) of Medical Claims experience + 2+ year(s) using a computer with Windows ... **Job Title** : Medial Claims Processor **Industry** : Healthcare **FSLA status** :...this Role the candidate will be responsible for:** + Processing of Professional and Hospital claim forms files by… more
- University of Washington (Seattle, WA)
- …Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is responsible for ... claims review, clearing claim edits, and timely and accurate...clear the charge edit as appropriate. + Resolve all pre- processing claim edits that indicate errors needing correction. This… more
- Elevance Health (Nashville, TN)
- …I :** Requires a HS diploma or GED and a minimum of 3 years of claims processing experience; or any combination of education and experience which would provide ... Auditor II** - all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. + ** Claims ...or GED and a minimum of 5 years of claims processing experience including a minimum of… more
- HCA Healthcare (Nashville, TN)
- …reports, assigns work, maintains weekly on hand reports Monitors performance and claims processing times to ensure compliance with performance standards. Perform ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...processors and claims examiners. Technical competence with claims processing software. Supervisory skills in … more
- New York State Civil Service (Albany, NY)
- …include, but are not limited to:* Oversee all aspects of workers compensation claims processing from inception to closing* Initially determine the compensability ... NY HELP Yes Agency Insurance Fund, State Title Claims Services Representative 1/Trainee 1/2 - NYHELPS Occupational...correct recipient and rate of compensation* Schedule or waive medical examinations as necessary * Analyze medical … more
- Dignity Health (Bakersfield, CA)
- … Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves ... Qualifications:** + Minimum of 5 years of experience in claims processing , quality assurance, or a related...providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a… more
- NTT DATA North America (Chicago, IL)
- …our technology team to identify patterns and opportunities for automation + Share claims processing expertise with team members and contribute to knowledge base ... systems + Participate in the continuous improvement of our claims processing workflows + Break down complex...or GED **Preferences** + Background in benefits administration or medical billing + History of implementing process improvements in… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills &… more
- Molina Healthcare (NE)
- …likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing . + Reevaluates medical claims and associated ... **Job Duties** + Facilitates clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an… more
- Consolidated Electrical Distributors (Irving, TX)
- Summary Job title: Loss Control Claims Coordinator II Job ID: null Department: Loss Control Location: null-null Description Summary: Consolidated Electrical ... Inc. (CED), a large, nationwide wholesale electrical distribution company, is seeking a Claims Coordinator to join the Loss Control Department. The Claims … more