- Molina Healthcare (Phoenix, AZ)
- …and state specific policies and regulations in order to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing ... appropriate modules within the core processing system (QNXT). Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these… more
- Summit Health Medical Group (Bend, OR)
- …a thriving practice within a financially secure, physician-driven, multispecialty setting. As an expansion of Summit Health's Gynecology Department, we are seeking ... an NP (prior experience preferred) who is passionate about...Our team works closely with primary care and other medical specialties to provide excellent quality care to members… more
- Cognizant (St. Paul, MN)
- …Insurance Customer Service with managed care plans or directly with CMS Billing and Coding - Medical Insurance Knowledge of Member/Provider Appeals ... appeals that will involve research of member benefits, eligibility, provider contracts, billing and coding , Utilization Management and state Medicaid policies.… more
- Cardinal Health (Little Rock, AR)
- …skills and prioritizes getting the right things done. Responsibilities Submitting medical documentation/ billing data to insurance providers Researching and ... denied and rejected claims Preparing, reviewing, and transmitting claims using billing software including electronic and paper claim processing Following up on… more
- Elevance Health (St. Louis, MO)
- …and post implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, enrollment & billing transactions and ... BS/BA; a minimum of 3 years related experience in an enrollment and billing , claims and/or customer...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- Cleveland Clinic (Cleveland, OH)
- …criteria, identify problems and refer for resolution Basic knowledge of medical records coding standards Proficiency with Microsoft Office Knowledge ... of billing practices, identification of billing problems and adequacy of documentation Knowledge and experience...of time. Requires constant attention to detail, reading of medical records, and meeting deadlines. Works in an… more
- CVS Health (Columbus, OH)
- …in the area of healthcare fraud, waste and abuse matters. Working knowledge of medical coding ; CPT, HCPCS, ICD10 Proficiency in Microsoft Office with advanced ... clinical findings Initiates proactive data mining to identify aberrant billing patterns Makes referrals, both internal and external, in...ability to understand and analyze health care claims and coding Ability to travel up to 10% (approx. 2-3x… more
- UPMC (Pittsburgh, PA)
- …9 and CPT codes, and knowledge of third party healthcare coverage and medical billing practices required. Experience with mainframe and personal computer-based ... and forwards all credentialing information to physician offices and Medical Staff Services. Print and distribute a daily OR...advise them on method of payment. Responsible for ICD-9 coding for correct diagnosis entry and CPT coding… more
- Trinity Health (Grove City, OH)
- …assistance and/or patient financial responsibility. Collects payments and facilitates resolution of billing questions. Acts as an information resource to other ... Understands relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare, Medicaid… more
- UnitedHealth Group (Dedham, MA)
- …opportunities with Atrius Health, part of the Optum family of businesses. We're an innovative health care leader and multi-specialty group practice, delivering an ... necessary health screening for all patients entering the practice for medical appointments. Verifies patient demographics and insurance information, making any… more
