- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Medicare /Medicaid Claims **Equal Employment Opportunity** CareFirst BlueCross ... **Resp & Qualifications** **PURPOSE:** The Quality Assurance Specialist III is an advanced-level auditor position performing in-depth system and procedural audits.… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking a Regional Claims Specialist (I/II/Sr.). This is a full-time position and offers a hybrid schedule after ... training. The Regional Claims Specialist will be responsible for contacting...Knowledge of and experience working Work with liens and Medicare Set-Asides to secure full and final settlements +… more
- CenterWell (Jefferson City, MO)
- …+ Guide/instruct and support agency personnel encompassing all aspects of insurance and non- Medicare claims processing. + Prepare input data forms to update ... help us put health first** As an **Accounts Receivable Specialist ** , you will: + Ensure the coordination of...timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily.… more
- Ventura County (Ventura, CA)
- …for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical ... processing claims for timely reimbursement and compliance with Medi-Cal, Medicare , and general insurance requirements. Please include the following in your… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Medicare Supplement, and individual plans._** **Responsibilities** **Cash Recovery Specialist ** Reviews and research routine to moderately complex refunds and ... projects, etc.). . Performs other duties as assigned. **Qualifications** **Cash Recovery Specialist ** . Associate Degree in Business or Healthcare Administration… more
- State of Massachusetts (Boston, MA)
- …of liens are issued and deadlines are met. * Report out on findings as needed. * Medicare Claims Reporting and Claim Handling * * Work with A&F IT to ensure ... of the Director of Workers' Compensation, the Workers' Compensation Specialist is responsible for overseeing specialty programs that fall...this field. * Ensure receipt, review and acknowledgement of claims made by Medicare to HRD/WC. *… more
- Elderwood (Buffalo, NY)
- …The Pharmacy Billing Specialist is responsible for electronic billing of Medicare , Medicaid and Third Party Insurance claims , utilizing Frameworks LTC ... Pharmacy Billing Specialist Responsibilities: + Electronic billing of Medicare , Medicaid and Third Party Insurance claims utilizing Framework… more
- Texas A&M University System (Dallas, TX)
- Job Title Clinical Coding Specialist I Agency Texas A&M University Health Science Center Department Oral Surgery Proposed Minimum Salary $22.00 hourly Job Location ... What we want The College of Dentistry is looking for a Clinical Coding Specialist I to serve in the Comprehensive Dentistry department. We desire an individual who… more
- Trinity Health (Livonia, MI)
- …efforts for professional services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims Processing Manual, ... services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims...in a health care setting. The minimum of an associate 's degree is required, Bachelors preferred. 2. Additional coding… more
- The Arora Group (Fort Sam Houston, TX)
- …thirty minute or one-hour (non-compensable) lunch break. DUTIES OF THE MEDICAL BILLING SPECIALIST : + Monitors insurance claims and patient accounts in work ... + Manages and works assigned queues to appropriately process claims , including clearing house claims . + Research...Certified Professional Biller (CPB) or Certified Billing and Coding Specialist (CBCS) or Associate college degree in… more
- Independent Health (Buffalo, NY)
- …perks, benefits and commitment to diversity and inclusion. **Overview** The Billing Specialist assists with the various activities of the pharmacy operations not ... requiring the professional judgment of the pharmacist. The Billing Specialist is primarily responsible for completing the billing of both pharmacy and medical … more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II - MCLA Team Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more
- Community Health Systems (Knoxville, TN)
- **Job Summary** The Billing Specialist II is responsible for serving as primary contact person for insurance companies or other payers. This position performs all ... needed research to ensure claims are filed timely, accurate and efficient in accordance...+ Complies with all policies and standards. **Qualifications** + Associate Degree in healthcare related field preferred + Technical… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and… more
- Amgen (Fort Worth, TX)
- …and transform the lives of patients while transforming your career. **Field Reimbursement Specialist - Dallas South, TX** **What you will do** Let's do this. Let's ... the world. In this vital role the Field Reimbursement Specialist (FRS) will manage defined accounts within a specified...the products are covered under the benefit design (Commercial, Medicare , Medicaid) + Serve as a payer expert for… more
- Trinity Health (Howell, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Fairview Health Services (St. Paul, MN)
- …M Health Fairview are looking for a Remote Outpatient Clinical Documentation Integrity (CDI) Specialist to join our team! This is a fully remote position that is ... physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements. + Ensures clinical documentation… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that… more
- HCA Healthcare (Nashville, TN)
- …invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Editor Specialist with Work from Home you can be a part of an organization that ... We are looking for an enthusiastic Inpatient Coding Editor Specialist to help us reach our goals. Unlock your...with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assigns interim… more
- Trinity Health (Ann Arbor, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... school diploma or an equivalent combination of education and experience. Associate degree in Accounting or Business Administration highly desired. **Experience:** +… more