- Humana (Harrisburg, PA)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve ... the resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and… more
- Intermountain Health (Harrisburg, PA)
- …payments to patient accounts, using both electronic and manual posting systems + Research , validate and make adjustments to payment postings. Follow up in accordance ... procedures and policies with an overall goal of account resolution + Post correspondence, zero payments, denials and any...additional items received from insurance to patient accounts + Research and follow-up on missing information, such as EOB… more
- AmeriHealth Caritas (Philadelphia, PA)
- …is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the full life cycle of assigned member and/or ... case intake, investigation, and documentation to ensure accurate and timely resolution consistent with federal state, and accreditation standards. The Specialist… more
- UPMC (Pittsburgh, PA)
- …Internal Audit, Client Audit teams) to understand issues, identify solutions and facilitate resolution . + Serve as an SIU representative at internal and external ... prescribing and utilization to identify potential clinical care issues; prepayment review of claims , and prepayment review of unlisted codes. Claims analysis and… more
- Select Medical (Camp Hill, PA)
- …quarterly bonus after 90-day probation. **Patient Account Representative / Claims Resolution Specialist** Research -focused role requiring independence ... seminars + Annual Hershey Park trip **Responsibilities** **Medical Records Representative ** Seeking candidates with strong typing and computer skills, attention… more
- Globus Medical, Inc. (Audubon, PA)
- …This role serves as a primary contact for employee inquiries, claim research , and issue resolution , ensuring compliance with applicable laws, regulations, ... Administer Short-term/Long-term Disability and Family and Medical Leave Act (FMLA) claims , including tracking and documentation. + Manage workers' compensation … more