- Arnot Health (Elmira, NY)
- …discourage preventable denials DUTIES AND RESPONSIBILITIES: 1. Retrospectively determines medical necessity and appropriateness of admission and stay in accordance ... authorization, untimely filing, coordination of benefits, services type issues, and insurance or service verification. Identify patterns of common denial errors,… more
- Timber Dental (Portland, OR)
- …and coordinate supportive services of the Practice. We verify insurances and work all insurance claims through other vendors, so your team's main focus can ... $65-70k DOE and potential of a $1,000 monthly bonus based on performance + Medical Insurance (for full-time employees) + An Awesome Dental Plan + Paid Time Off… more
- Commander, Navy Installations (Napa, CA)
- …members, and caregivers in accordance with Privacy Act and Health Insurance Portability and Accountability Act (HIPAA) regulations. Conducts initial assessment of ... service member and family to identify any non- medical issues. Works alongside agencies and service providers to facilitate case coordination and information sharing.… more
- CVS Health (Annapolis, MD)
- …are met by driving resolutions for escalated issues related to claims payment, policies, accuracy of provider demographic information and contract interpretation. ... conflict management, an independent worker and self-starter. + Prior Medicare and Commercial insurance experience + Must be willing to travel 10-15% to providers. +… more
- Centene Corporation (Augusta, GA)
- …related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, claims , contracting ... utilization management, or clinical operations. Project management experience at a medical group, IPA, or health plan setting. Proficient in HEDIS/Quality measures,… more
- Catholic Health Services (Centereach, NY)
- …similar EMR platforms Experience with retail pharmacy prescription processing and claims adjudication Prior experience on pharmacy dispensing systems and familiar ... with insurance adjudication processes This role involves working with a...with a broad array of complex disease states and medical conditions. Candidates should be comfortable working with clinical… more
- Samsung SDS America (Dalton, GA)
- …Investigate and report any service failures, accidents, misconduct, security concerns, or claims to the relevant department for prompt resolution and support. + ... suite of programs to support our employees: + Top-notch medical , dental, vision and prescription coverage + Wellness program...and savings plan + Flexible spending accounts + Life insurance + Paid Holidays + Paid Time off +… more
- LogixHealth (Dania Beach, FL)
- …combination of education and experience required + 5-7 years Emergency Department Medical Coding and 3-5 years auditing experience required + Experience with ... multiple types of medical records required + Coding certification required (CPC, CCS,...and vision, 401(k), PTO, paid holidays, life and disability insurance , on-site fitness center and company-wide social events. About… more
- CareFirst (Baltimore, MD)
- …change management. **Knowledge, Skills and Abilities (KSAs)** + Proficient in standard medical practices and insurance benefit structures. + Proficient in ... and pursues a responsive system for authorization of services and approved claims . + Prepares retrospective reviews, case appeals, billing coordination, and clinical… more
- South Middlesex Opportunity Council (Framingham, MA)
- …receipt and acceptance by payors. + Reconcile and resolve issues related to claims submissions. + Confirm insurance eligibility and research and resolve ... you must have at least 2-3 years' experience in medical billing with a focus on payment posting and...during their first year of employment. + Employer-paid Life Insurance & AD&D and Long-Term Disability for full-time employees.… more