- UPMC (Pittsburgh, PA)
- UPMC Health Plan and WorkPartners is hiring a full-time Medical Only Claims Specialist II . This role will predominantly work remotely. The UPMC ... WorkPartners Workers' Compensation Medical Only Claims Specialist II reports to the Workers' Compensation Supervisor. This is an intermediate level… more
- Guthrie (Sayre, PA)
- …payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request ... payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy,...submission issues. 2. Works closely with a Denial Resolution Specialist or Billing Specialist II … more
- AON (Fort Washington, PA)
- …Referral and Claim Specialist ! This is an exciting opportunity for an Operations Specialist II , who will report directly to the Assistant Vice President to ... Email/Correspondence teams + Responsible for sending 1st Report of Claims to carrier partner for Healthcare Individual and Healthcare...! This is an exciting opportunity for an Operations Specialist II , who will report directly to… more
- Globus Medical, Inc. (Audubon, PA)
- At Globus Medical , we move with a sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our team is ... lives as quickly as possible. **Position Summary:** The IT Technical Support Specialist to provide on-site technical assistance for the Globus headquarters located… more
- Guardian Life (Bethlehem, PA)
- …Overview:** We are seeking a highly skilled and proactive **Data Management Operations Specialist ** to join our Data Management team in the insurance industry. This ... Knowledge:** Familiarity with industry regulations such as GDPR, HIPAA, and Solvency II , ensuring data management practices are compliant with legal standards. +… more
- Highmark Health (Harrisburg, PA)
- …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure… more
- Guthrie (Sayre, PA)
- Position Summary: Fulfills all requirements of an Insurance Billing Specialist II as well as identifies, analyzes and takes the necessary action to submit ... complex appeals to insurance payers. Reviews all medical chart and account documentation in order to determine appropriate coding and initiate corrected claims … more