- Providence (Mission Hills, CA)
- …of functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. ... Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer… more
- IQVIA (Columbia, OH)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team. In this position, you… more
- MVP Health Care (Rochester, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess… more
- Ascension Health (Jacksonville, FL)
- …party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review ... claims for accuracy, including proper diagnosis and procedure codes. + Review claim rejections and communicates with payers to resolve billing issues. + Prepare and… more
- Dignity Health (Bakersfield, CA)
- … discrepancies for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), ... accurate records for audit purposes. - Collaborate with internal departments, including claims processing , UM, compliance, and provider relations, to develop and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …management. Level II (in addition to Level I Accountabilities) * Resolves moderately complex claims processing and claims history audits. * Manages a ... Level III (in addition to Level II Accountabilities) * Performs complex claims processing , claims history audits and policy interpretation, ensuring all… more
- Cedars-Sinai (CA)
- …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... claims required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred. **About Us** Cedars-Sinai is… more
- WelbeHealth (Little Rock, AR)
- …other established quality standards + Work alongside manager to establish and maintain claims processing rules that meet all regulatory and business requirements ... complex managed care environment + In depth experience with Medicare and Medicaid claims processing + Demonstrated skills within Microsoft Office Applications &… more
- CVS Health (Franklin, TN)
- …with funeral homes, beneficiaries and family members, and ensures accurate and timely claims processing . Contributes to the efficient and accurate handling of ... stakeholders to resolve any discrepancies or issues related to claims . + Determines if claims processing...issues related to claims . + Determines if claims processing activities comply with regulatory requirements,… more
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