- Guidehouse (Lewisville, TX)
- …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative ** is an extension of a client's business ... Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service... Follow-up + Customer Service + Billing + UB-04 claims + Complete all business-related requests and correspondence from… more
- American Express (Phoenix, AZ)
- …product information by using tools available. + Maintaining state compliance for reporting, Medicare , insurance claims and audit functions relative to the ... you make an impact in this role?** AMEX Assurance Co. (AAC) provides insurance protection for American Express Card Members through implicit card benefits, and… more
- Sedgwick (Sun Prairie, WI)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative , Auto | Property Damage | Remote **PRIMARY ... PURPOSE** **:** To process low level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer support… more
- Trinity Health (Davenport, IA)
- …the banking industry or a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, ... performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities or an equivalent combination of education… more
- Highmark Health (Buffalo, NY)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- Humana (Augusta, ME)
- …resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services ... a part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations that… more
- University of Washington (Seattle, WA)
- …on accounts in the EPIC billing system. + Update/edit charge entry detail for Medicare claims that have been corrected and need to be resubmitted electronically. ... Medicine Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …of Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Travelers Insurance Company (Diamond Bar, CA)
- …Bar or Irvine, CA locations. Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
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