- CGI Technologies and Solutions, Inc. (Albany, NY)
- **Business Claims Processing Specialist** **Category:** Administration **Main location:** United States, New York, Albany **Position ID:** J1024-0536 ... in the provision of affordable housing has an opening for a Business Claims Processing Specialist in Albany, NY. This is an opportunity to join an energetic… more
- Access Dubuque (Dubuque, IA)
- Claims Processing Representative **Grand River Medical Group** 1 Positions ID: 1343279 Posted On 10/30/2024 **Job Overview** ** Claims Processing ... options available Grand River Medical Group is seeking an experienced Claims Processing Representative to join our Revenue Cycle Team. You will provide… more
- Providence (Mission Hills, CA)
- …the supervision of staff and for overseeing the day-to-day operations of the Claims Processing and UM Denial Letter Units. Additional responsibilities include ... Schedule:** Full time **Job Shift:** Day **Career Track:** Leadership **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Billing/ Claims Processing + **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM + **Hospital:** Ascension St. Vincent + **Location:** ... party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review … more
- AssistRx (Orlando, FL)
- …to support all operational and financial processes related to claim processing activities ensuring effective day-to-day operations and provide ongoing Copay program ... customer business review meetings. Responsible for utilizing forecasts and analyzing claims data to determine Copay utilization, escrow account replenishment needs,… more
- Veterans Affairs, Veterans Health Administration (Denver, CO)
- Summary This position is in the Beneficiary Claims Processing Unit, CHAMPVA program, 3.1 Network Development and Operations, Integrated External Networks, ... The Claims Examiner reports to the Supervisor of the Beneficiary Claims Processing Unit. The primary function of the position is initial evaluation and … more
- Molina Healthcare (MI)
- …claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual ... standard principles and applicable state specific policies and regulations to identify claims processing errors + Applies claims processing and technical… more
- Robert Half Accountemps (Plantation, FL)
- … as per the guidelines of the CMS Platform * Utilize Cl Programming for efficient claims processing * Manage benefit functions related to medical claims * ... as needed Requirements * Proficiency in using Allscripts software for medical claims processing * Familiarity with Cerner Technologies for managing healthcare… more
- Fallon Health (Worcester, MA)
- …complex and high dollar claims . + Ensures accuracy and timeliness of claims processing to minimize late payment interest penalties and ensure compliance with ... Facebook, Twitter and LinkedIn. **Brief Summary of purpose:** The Claims Examiner should have thorough claim processing ...The Claims Examiner should have thorough claim processing knowledge at a complex level.. Thorough understanding of… more
- Insight Global (Nashville, TN)
- …to work from 9 AM to 5 PM EST / 8 AM to 4 PM CST. Claims Processing : 75% of the role involves processing claims within our proprietary claims ... of contact at correctional facilities or account managers for verification before processing claims . We are a company committed to creating diverse and inclusive… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- …(ML), data analysis, Business Intelligence and Data Visualizations to streamline the claims processing , Payment Integrity and healthcare analytics systems. This ... Collaborate with data scientists to extract insights that help optimize claims processing and reduce time to settlement. Develop Power BI visualization to… more
- AON (Chicago, IL)
- …Hotels, Vendors on any disputes/issues, updates, escalations, or discrepancies. + Ensure all claims processing adheres to internal policies, as well as local, ... Vendors on any disputes/issues, updates, escalations, or discrepancies. + Ensure all claims processing adheres to internal policies, as well as local, state, and… more
- Highmark Health (Pittsburgh, PA)
- …**systems and technology** **will be essential.** **This includes k** nowledge of claims processing platforms, data management systems, and relevant technologies ... like AI/ML to optimize claims processing . **ESSENTIAL RESPONSIBILITIES** + Understand the department's and the company's strategic roadmap and competitive… more
- NJM Insurance (Trenton, NJ)
- …including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. + Level II - 3-5 years' experience as a ... strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. + Sr Level - 5+ years' experience as a Workers' Comp… more
- Crawford & Company (Fort Lauderdale, FL)
- …edjuster's claims handling professional-service methodology and its Web-based content claims processing and pricing platform/system - exclaim. + Operating ... with the Company's productivity and performance standards. + Work with Central Claims Processing to organize/direct the resources ( claims assistants,… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- …a must + Health care or pharmaceutical experience, particularly in a medical claims processing , billing provider, or insurance environment + Knowledge of EOB ... Prior experience in a high-volume processing setting (ie, doctor's office, claims processing department, etc.) a plus. + Will be trained to support programs,… more
- Centene Corporation (Austin, TX)
- …the subject matter expert for other Claims Liaisons. + Analyze trends in claims processing issues and identify work process solutions + Lead meetings with ... potential configuration related work process changes + Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing… more
- Anderson Trucking Service, Inc. (St. Cloud, MN)
- …and Experience + Associate/Bachelor's degreeoran equivalent combination of education experience in Claims Processing . + Minimum 3 years of experience handling ... St. Cloud, MN Wage: Depends on Experience Summary The Claims Examiner -I is primarily responsible for processing... Claims Examiner -I is primarily responsible for processing simpler to moderate, cargo, general liability, and physical… more
- Apex Health Solutions (Houston, TX)
- …day to day interactions with any vendor partners that have direct impact to claims processing or pricing rules. Identifies and implements new processes, vendors, ... and oversee user acceptance testing for any impacted changes to claims processing Demonstrate expertise in interpretation and serve as Subject Matter Expert… more
- Healthfirst (FL)
- …benefits, claims editing, reference data and system functionality within the claims processing system. + Analyze explanation of coverage documents to assist ... and eligibility administration systems (ie PowerMHS or any other claims processing systems). + Proficiency in medical terminology, medical coding (CPT4, ICD9… more