- Beth Israel Lahey Health (Burlington, MA)
- …provider documentation in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation review and ... annually or as introduced or required. 3. Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …workers' compensation insurance fund. The Fund's portfolio primarily consists of reimbursement claims to insurance carriers for a worker who had more than ... to negotiate with the injured party or their legal representative or the insurance carrier. The Special...The Special Funds Administrator is also required to meet Medicare quarterly reporting requirements, closely monitor claims … more
- HCA Healthcare (Overland Park, KS)
- …coding or billing errors from EOBs and work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims + ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- University of Rochester (Rochester, NY)
- …will make independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing ... as well as contact payer representatives to research/resubmit rejected claims to obtain and verify insurance coverage.... Coverage tab), review payer website, or contact payer representative as to why claims are not… more
- Trinity Health (Columbus, OH)
- …position until 4/4/2026 **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... Center for Medicare and Medicaid Services (CMS), Ohio Department of Insurance (ODI), NCQA and all applicable Federal regulations. + Develop a thorough… more
- ATI (Dallas, TX)
- …This role will provide advanced support in managing asbestos and other litigated claims , insurance matters, discovery, and legal operations platforms. The Senior ... representative depositions, case strategy coordination). + Review and manage available insurance coverage for claims received and complete necessary reporting… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid ... for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...environment PHYSICAL DEMANDS The physical demands described here are representative of those that should be met by an… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid ... is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial… more
- Walworth County (Elkhorn, WI)
- …trends as assigned. Timely prepares assigned monthly, quarterly and annual fiscal reports/ claims for HHS and LHCC federal and state funding. Understands and assists ... single audits. Assists in the compilation of data required for LHCC Medicaid/ Medicare annual reports or other state or federal reports. Completes accounting related… more
- Medical Mutual of Ohio (IA)
- …encompassing onboarding, training, sales support, new business submissions, commission assistance, claims management, and customer service. As the representative ... is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.… more