- CareFirst (Baltimore, MD)
- …physicians and/or ancillary providers as well as knowledge about contracting and claims processing . + Experience in revenue cycle management and value-based ... measure capture and proper use of CPT, HCPCS, and ICD 10 codes in claims submissions. Utilizes coding expertise, combined with medical policy, credentialing, and… more
- Ryder System (Augusta, ME)
- …action plans if deficiencies are noted. Monitors staff's workflow to ensure accurate processing of claims , timely establishment of reserves, reviews and logs ... : **SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling… more
- Sanford Health (SD)
- …to the work of health and healing across our broad footprint.** **Facility:** Remote SD (Central Time) **Location:** Remote , SD **Address:** **Shift:** Day **Job ... **Department Details** Flexible scheduling after training is completed. Fully remote /work from home. **Job Summary** The Insurance Representative processes and… more
- VetsEZ (CA)
- …citizenship required). Preferred Experience: + Prior experience in care coordination, claims processing , or patient engagement systems. + Practical experience ... develop, test, and operationalize AI-driven product ideas-such as automated claims triage, intelligent document processing , and conversational assistants-into… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Prior Authorization Technician - Remote Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Remote Type Fully Remote ... Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST ( REMOTE ) WHO WE ARE At Polaris Pharmacy Services, we're more than a… more
- Martin's Point Health Care (Portland, ME)
- …waste, and abuse investigatory techniques and strategies + Solid understanding of standard claims processing systems, operations, and claims data analysis + ... claim payments. This role focuses on preventing overpayments, identifying incorrect claims , and leading recovery efforts while improving system controls and… more
- The Cigna Group (Tempe, AZ)
- …create patient profiles in system if needed. + Prepare prescriptions for processing , including assessing validity of prescription. + Manually route orders to ... appropriate stage for processing , validation or clarity from Doctors' offices, insurances and/or...+ Accurately enter prescriptions into our system, run test claims , run test claims and support patients… more
- Molina Healthcare (Ann Arbor, MI)
- …years of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of ... Tricare, Pharmacy, etc.) + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems. + Demonstrated ability to use MS Excel/Access… more
- Option Care Health (Jackson, MS)
- …up on invoices submitted to ensure prompt and timely payment. Calls to verify that claims submitted were received and are in processing . Sends letters to the ... abilities, as well as internal equity and alignment with market data. **Benefits:** - Medical , Dental, & Vision Insurance -Paid Time off -Bonding Time Off -401K… more
- Cognizant (Dover, DE)
- …Medicaid policies. **Basic qualifications:** 2 years of Appeals and Grievance 1 Year of medical claims processing experience (Must be with a healthcare plan, ... **Provider Appeals & Grievances Specialist ( remote )** This is a remote position...provider's office) Medicaid & Medicare insurance customer service or claims processing 2 Years of medical… more