- Humana (San Juan, PR)
- …us put health first** Join Humana's dynamic Puerto Rico team as a Claims Research & Resolution Representative and make a meaningful impact every day! In ... and third-party collection services to facilitate timely and accurate resolution of complex medical claims . + Utilizes...claims , call center, and provider associates to conduct research and analysis on pending claims issues.… more
- Dragonfly Health (Mesa, AZ)
- …discrepancies as needed. 5. Collaborate with the Customer Service team on complex claims research and resolution . 6. Understand Enclara Pharmacia's standard ... and correct authorizations in dispensing and PBM systems to ensure timely claims submission. Research and resolve rejected claims by contacting hospices for… more
- NTT DATA North America (Plano, TX)
- …as part of an overall sourcing strategy. NTT DATA currently seeks a Remote **Medical Claims Representative ** to join our team in **for a remote position** . This ... complete compliance training of NTT Data/Client -Work independently to research , review and act on the claims ...above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as… more
- The County of Los Angeles (Los Angeles, CA)
- …obtain a fair outcome through our consumer protection programs, including Small Claims Advisor, dispute resolution and mediation programs, immigration legal ... of tasks on a variety of consumer matters, including real estate, small claims court, mediation, dispute resolution , and other programs. Incumbents learn to… more
- Intermountain Health (Salem, OR)
- …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
- University of Virginia (Charlottesville, VA)
- …processed and followed up to meet the CBO Revenue Cycle performance metrics & representative Facility specific goals. They will also research and answer all ... The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing...from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and… more
- TEKsystems (Farmington, CT)
- …operations Required Qualifications + Minimum 3+ years of Hospital Billing (HB) claims follow‑up and denials resolution experience + Experience with Commercial, ... Insurance Follow‑Up Representative (Hybrid) Shift: 7:30 am - 4:00 pm...hospital billing operations. This role focuses on resolving medical claims denials, conducting detailed follow-up with insurance payors, and… more
- University of Rochester (Rochester, NY)
- …insurance or contracted service accounts in order to bring about prompt account resolution and revenue collection from complex claims , high dollar claims ... to successful closure and obtain maximum revenue collection. Researches, corrects, resubmits claims , submits appeals and takes timely and routine action to resolve… more
- Beth Israel Lahey Health (Charlestown, MA)
- …helps to resolve callers' issues, retrieving critical information that impacts the resolution of current or potential future claims . 3. Establishes relationships ... within the Central Billing Office. 17. Assists the Supervisor, Billing with the resolution of complex claims issues, denials, appeals and credits. 18. Completes… more
- CHS (Clearwater, FL)
- …call resolution and satisfaction. The Member and Provider Service Representative (MPSR) is critical to PAS' success, effectively and efficiently handling calls ... **Overview** ** ** **Medical Insurance Call Center Representative | Member and Provider Services Representative...Supervisor. + For any calls or correspondence where additional research is necessary, clearly explaining to the caller the… more