- 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
- UPMC (Pittsburgh, PA)
- …customer service experience or call center experience required. OR1 year health insurance call center and claims adjustments experience required. + Keyboard ... **Purpose:** The Provider Service representative acts as an advocate for Health Plan...of Public Welfare (DPW) laws and standards, Department of Insurance (DOI) laws and standards, Department of Health (DOH)… 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
- Avera (Sioux Falls, SD)
- …within designated authority limits. + Conduct risk assessments for group and Medicare Supplement health plan accounts. + Provide insights on risk profiles and ... to enhance underwriting processes and implement best practices. + Analyze claims experience and trends to inform underwriting decisions and contribute to… more
- Ketchikan Indian Community (Ketchikan, AK)
- …for payment of medical/dental services for other resources such as Medicare , Medicaid, private insurance , Veteran's Administrations, Industrial Accident, BEC, ... etc. + Initiates follow up with fiscal pending claims , delayed payments, and other pertinent documents/information. + Sends letters to patients and healthcare… 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
- State of Colorado (Pueblo, CO)
- …new information, changes in policy/procedure/instructions, etc. + Reports any claims of any type of harassment/workplace violence, alerts public safety/charge ... name check and fingerprint check, ICON Colorado court database, Medicare fraud database, Reference Checks, Professional License verification (licensure… more
- Lake Erie College of Osteopathic Medicine (Bradenton, 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
- AbbVie (Morgantown, WV)
- …order 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
- Fallon Health (Worcester, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive ... case inventory/assignments, etc.) + Assist and support the Provider Relations Representative on Provider enrollment initiatives. + Escalate critical issues and… more