- Highmark Health (Dover, DE)
- …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
- 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
- Intermountain Health (Logan, UT)
- …and extensive knowledge in the health insurance industry (Commercial Insurances, Medicare , and Medicaid); health claims billing or Third Party contracts. ... call to schedule and register for services. The Enhanced Scheduler reviews insurance benefit information, estimated costs, and payment options with the patient. Also… 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
- State of Colorado (Denver, CO)
- …be assigned to civil investigations in support of the Colorado False Claims Act. Additionally, the incumbent will provide technical training, advice and assistance ... and Federal regulations; + Work experience with Medicaid or Medicare regulations and statutes; + Experience investigating document intensive...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- Avera (Sioux Falls, SD)
- …+ Directs the preparation, completion and filing of third party payor insurance reimbursement claims , both electronic and paper formats. + Processes ... explanation of Medicare Benefits for supplemental insurances. + Verifies bill accuracy...other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to… more
- AbbVie (Houston, TX)
- …policies to educate providers on payer issues, coding changes, and appropriate claims submission processes + Liaise with AbbVie's Access and Reimbursement support ... care + Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics + Strong understanding of drug acquisition and dispensing… more
- Lake Erie College of Osteopathic Medicine (Defuniak Springs, FL)
- …with responsibility for protocols that will aid patients in the reimbursement of insurance claims ; + Assist in the recruitment, interviewing, and hiring of ... understanding of dealing with and processing Florida Medicaid and Medicare ; + Possess a strong sense of patient advocacy,...experience; + Faculty member will commit to being a representative of LECOM by being actively involved in the… more