- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We offer a… more
- International Medical Group (Indianapolis, IN)
- …hospital, and other insurance companies; initiating or conducting investigation of questionable claims . + Documents medical claims actions by completing ... ; documenting actions; maintaining their imaging queues; maintaining quality audit standards and ensuring their outcomes are following the...values. QUALIFICATIONS + At least 1 year of prior medical claims processing experience OR willing to… more
- LA Care Health Plan (Los Angeles, CA)
- … Claims is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans ... contractual requirements. Communicate issues and findings that would affect the audit results. Perform claims audits for all medical groups and health plans… more
- Elevance Health (Houston, TX)
- **External Audit Facilitator** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while ... a dynamic and adaptable workplace. Alternate locations may be considered. The **External Audit Facilitator** is responsible for managing the process for claims … more
- CenterLight Health System (NY)
- …monies and proper application of transaction by our TPA. + Perform in-depth claims audit to confirm that all medical claims paid and denied accurately. ... claims department by timely and accurate processing of claims appeals and performing claims audit...enhance claim workflow and efficiency. + Analyze patient and medical information to identify Coordination of Benefits (COB), Worker's… more
- Guidehouse (El Segundo, CA)
- …is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other ... any and all related job duties as assigned. **_The medical biller will be working a Hybrid schedule based...Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides… more
- LA Care Health Plan (Los Angeles, CA)
- …Summary The Specialty Plans Auditor III is responsible for planning audits and audit work programs that address appropriate claims and financial compliance ... Senior Health Care Audit Analyst Job Category: Accounting/Finance Department: Financial Compliance...also LA Care contractual agreements. The position handles DMHC claims data submissions for LA Care and its Plan… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
- Novant Health (NC)
- Job Summary + The Coding Audit Response Specialist position responds to external and internal audits that include an assessment of ICD-10- CM/PCS, CPT or HCPCS codes ... the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. + Audits will include but will not be limited to: coding… more
- Novant Health (NC)
- Job Summary + The Coding Audit Response Specialist position responds to external and internal audits that include an assessment of ICD-10- CM/PCS, CPT or HCPCS codes ... the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. + Audits will include but will not be limited to: coding… more
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