- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Research Specialist will oversee and manage research efforts related to claims overpayments, ... point of contact for the providers and/or provider relations team regarding claims research issues, facilitating effective communication and resolution of… more
- UPMC (Pittsburgh, PA)
- …solving problems, helping others, and working with purpose? As a Direct Member Reimbursement Claims Service Specialist I at UPMC Health Plan, you'll be at the ... meet our quality and compliance standards. As the DMR Claims Service Specialist , you are a trusted...during your scheduled hours, ready to answer questions, conduct research , and provide clear, empathetic support. What You'll Be… more
- Dignity Health (Bakersfield, CA)
- …and efficiency. The Claims Quality Specialist will work closely with the Claims Research colleague and other team members to enhance claims processes ... **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed… more
- Cedars-Sinai (Los Angeles, CA)
- …environment that fuels innovation. **Req ID** : 13210 **Working Title** : Revenue Cycle Specialist III (PB Claims ) **Department** : CSRC PB - Group 3 CSMCF ... reputation for excellence! Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a...I be doing in this role?** The Revenue Cycle Specialist III works under general supervision and following established… more
- Rising Medical Solutions (Tampa, FL)
- The Claims Specialist will assist in reviewing, processing, and coordinating claims accurately in accordance with the program requirements while ensuring ... + Maintain ongoing knowledge of program requirements + Analyze and process claims for accuracy, eligibility, and benefits coverage + Retain and strengthen… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr....role will also be responsible for timely review and research , as necessary on all new and revised coding… more
- Commonwealth Care Alliance (Boston, MA)
- …Quality Assurance for further investigation or configuration updates. + Document all research , findings, and outcomes in claims systems (eg, Salesforce, Facets) ... 011250 CCA- Claims **_This position is available to remote employees...at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims … more
- CVS Health (Monroeville, PA)
- …the Monroeville area, has an opportunity available for a full time Pharmacy Claims Biller/Adjustment Specialist . As a Biller/Adjustment Specialist , you will ... ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Insurance Fund, State Title Information Technology Specialist 2 (Programming) ( Claims Medpay DBL-PHS) (NYHELPS) Occupational Category IT ... procedures, functions. * Design/create websites, APIs, and batch processes. * Research trending technology and assist management in implementation of new… more
- Ascension Health (Austin, TX)
- …outside agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes. + ... by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. +… more
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