- Guidehouse (El Segundo, CA)
- …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative ** **(Hospital Claims )** is an ... **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS 1500… more
- Sedgwick (Concord, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation | Claims Representative (Future Medical)| In-Office ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Sedgwick (Milwaukee, WI)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Liability **PRIMARY PURPOSE** : To process ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Humana (Seymour, IN)
- …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer support… more
- Highmark Health (Buffalo, NY)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- NJM Insurance (NJ)
- NJM's WC Claims Department is seeking an experienced Claims Specialist, Sr. who lives in Western or Central PA to provide on-site service to our policyholders ... This is a 100% remote position which includes virtual claims handling for customers in any area of PA...+ 5+ years' experience as a Workers' Comp Claim Representative , or comparable knowledge and experience with various aspects… more
- Allied Universal (Mission Viejo, CA)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …of Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Travelers Insurance Company (Irvine, CA)
- …Bar or Irvine, CA locations. Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
- Travelers Insurance Company (Charlotte, NC)
- …**Target Openings** 2 **What Is the Opportunity?** Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
- Banner Health (Tucson, AZ)
- …Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs ... settings by including remote and hybrid opportunities. As a **Provider Experience Representative ** for Banner Plans & Networks you will take inbound calls answering… more
- Travelers Insurance Company (Rancho Cordova, CA)
- …under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and ... Claim team is committed to partnering with our business insurance customers to help their injured employees return to...you will handle all aspects of a workers compensation claims . In this role, you will learn how to… more
- Humana (Lansing, MI)
- …the ability to read, write, and speak English and Spanish + Prior experience with Medicare + Experience with the Claims Administration System (CAS) and MHK + ... caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic… more
- Surgery Care Affiliates (Long Beach, CA)
- …for Primary insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or ... guidelines and the process of collecting over the counter payments/deductibles/copay/co- insurance . Knowledge of payer contracts including Medicare , Medicaid… more
- Ellis Medicine (Schenectady, NY)
- …outgoing data is accurate. + Review and resolve outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are ... The Accounts Receivable Representative will be responsible for achieving accurate and...+ Review Billing Exception Report for Revenue Management, the Medicare system (FISS), and the claims scrubber… more
- Ascension Health (Austin, TX)
- …of the daily claims reconciliation process. + Prepare and complete claims for commercial insurance companies, third party organizations and/or government or ... 1345 Philomena Austin, Texas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
- Care Plus NJ (Paramus, NJ)
- Accounts Receivable Representative Location:1 Kalisa Way, Paramus NJ On-site40 hours M-F: 8am-4pm or 9am-5pm Salary: $52k What We Offer: + Health, Dental and Vision ... Employee Discount and Rewards Program + Life & AD&D insurance ; STD & LTD coverage Note: That's not all!...The role requires strong knowledge of NJ Medicaid and Medicare billing, collaboration with clinical and executive teams, and… more
- Primary Health Care (Des Moines, IA)
- …and dental/medical billing requirements. + Experience working with dental/medical insurance contractual agreements, Medicare and Medicaid regulations, payment ... provide healthcare and supportive services to all, regardless of insurance , immigration status, or ability to pay. Based on...in Ames, Des Moines, & Marshalltown. As a Billing Representative III, you will be is responsible for timely… more
- Guidehouse (San Marcos, CA)
- …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative - Hospital A/R Emphasis** is an extension ... three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials +... + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service… more
- US Anesthesia Partners (Austin, TX)
- …requirements of the job with or without a reasonable accommodation) + Contacts insurance companies for status on outstanding claims . + Processes and follows ... Overview The Accounts Receivable Representative III is responsible for collecting outstanding accounts...up on appeals to insurance companies. + Refiles claims as needed.… more