- Excellus BlueCross BlueShield (Rochester, NY)
- …Interacts with Operations, Enrollment and Billing, Customer Care, Claims , Advocacy, Clinical Operations, Medical Affairs and Finance/Underwriting Departments ... process review. * Attends meetings and/or trainings as a representative of the Account Service Team and shares the...pressures and demands. * Ability to complete required internal Medicare Training per Center for Medicare Services… more
- Emory Healthcare/Emory University (Duluth, GA)
- …Review and monitor patients ? accounts to improve revenue and timely processing of claims . + Responsible for financially clearing patients prior to, at the time of ... service, or during inpatient admission by collecting payment, determining insurance eligibility, and/or evaluating for financial assistance. + Requires knowledge of … more
- Highmark Health (Denver, CO)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a… more
- Queen's Health System (Honolulu, HI)
- …implementing process changes, to minimize and/or prevent denials. * Follows up on insurance claims with outstanding balances; leads meetings with payors to ... * Four (4) years recent progressively responsible experience as a Patient Accounts Representative in an acute care facility, demonstrating good working knowledge of … more
- Apex Health Solutions (Houston, TX)
- …leadership role. Health plan or managed care industry experience preferred (eg, Medicare Advantage, Medicaid, or commercial insurance ). Strong understanding of ... with proven experience in health plan finance, including premium revenue, claims reserves, medical loss ratio analysis, and regulatory reporting. The Controller… more
- Mohawk Valley Health System (Utica, NY)
- …in order to promote financial stability within the Hospital. Experience in billing Medicare , Medicaid, Commercial Insurance , HMOs, and Worker's Comp/No Fault is ... is a plus. Core Job Responsibilities + Promotes a professional working relationship with insurance companies. Knows each payor representative and uses them as a… more
- WestCare Foundation (Henderson, NV)
- …organization. + Oversee all revenue cycle operations, including patient registration, insurance verification, coding, charge capture, claims submission, payment ... knowledge of healthcare billing systems, coding guidelines (ICD-10, CPT), Medicare /Medicaid, commercial insurance , and reimbursement methodologies. +… more
- Logan Health (Kalispell, MT)
- …service to stakeholders for questions and concerns. + Responsible for all Medicare , Medicaid, and Case Management insurance denials processing as applicable ... may not be limited to; billing, payment posting, collections, payer claims research, customer service, accounts receivable, etc. Our Mission: Quality, compassionate… more
- Logan Health (Kalispell, MT)
- …other regulatory requirements per department protocol; exhibits overall knowledge of claims and authorization processing for insurance companies including ... + Current CPR. + Possess knowledge of rules and regulations pertaining to Medicare , Medicaid and other payer types. + Current Notary Public certification. + Possess… more
- Elevance Health (Atlanta, GA)
- …responding to financial risks inherent in the pricing and development of health insurance products. **How you will make an impact:** + Prepares and interprets data ... of business and/or product. + Serves on major, multi-function projects as Actuarial representative . + Organizes and directs the staffing and workflow of the section.… more