- Option Care Health (Columbus, OH)
- …raw data form. Reports must be processed for meaningful interpretation by others. Adjudicate all disputes over marketing territories that may arise, from time-to-time ... amongst team.Responsible for hiring/firing/employee discipline/annual performance reviews of all staff.Distribute marketing material to all types of clients and will act as a resource regarding current market conditions and information gathered in the sales… more
- Staffing Now (Tampa, FL)
- Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services *Follow claims adjudication rules to assure that ... all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria * Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines *… more
- Bombardier (Opa Locka, FL)
- …corrective actions in SAP ensuring that work performed is adequately described to adjudicate warranty and special programs + Review and identify any labor, material, ... billings + Monitor open and yet to be billed pipeline work orders + Adjudicate warranty programs for Bombardier + Interpret, adjudicate , prepare, and invoice… more
- Magellan Health Services (Maryland Heights, MO)
- …edits and suspended claims. + Maintains and updates required reference materials to adjudicate claims. + Provides backup support to other team/group members in the ... the claims. + Utilizes reference materials and analyzes updated materials to adjudicate claims. This includes reviewing material updates daily and sharing feedback… more
- Executive Office for US Attorneys and the Office of the US… (Reno, NV)
- …In particular, please notify this Office if you currently represent clients or adjudicate matters in which this Office is involved and/or you have a family ... In particular, please notify this Office if you currently represent clients or adjudicate matters in which this Office is involved and/or you have a family… more
- Magellan Health Services (Maryland Heights, MO)
- …implement positive changes with a high level of quality and professionalism. + Adjudicate or submit claims and adjustments as required. + Track and trend performance ... and suspended claims. + Maintain and update required reference materials to adjudicate or submit claims. + Continuously identify process improvements that impact… more
- Kelly Services (Murfreesboro, TN)
- …and other PC applications + Typing skills: 40 wpm **Job Description:** + Adjudicate claims + Verify contract coverage and eligibility to NESNA policies, ascertain ... throughout policy. + Perform appropriate research with available tools to adjudicate claims, provide assistance to service contract policy holders repair facilities,… more
- Air National Guard (Arlington, VA)
- …and Adjudication in developing National Guard policy and examine, analyze, and adjudicate case records and prepare final decisions and other determinations on equal ... Duties Assist in the development of National Guard policy and examine, analyze, adjudicate case records and prepare final decisions and other determinations on equal… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …pricing files, contractual obligations, and billing practices, all to appropriately adjudicate provider and facility claims. + Use comprehensive knowledge of coding ... and in collaboration with teammates, physicians and other associates to appropriately adjudicate claims. + In-depth knowledge of HCPCS, CPT, ICD-10 and not otherwise… more
- J&J Family of Companies (Horsham, PA)
- …documents through designated review and approval cycles. + Facilitate, collate, and adjudicate author and reviewer comments. + Adjudicate and address quality ... assurance review. + Verify completion of required approvals. + Lead projects review/approval in automated workflow system. + Other duties as assigned. **Qualifications** **Education:** + Bachelor's degree required. Master's degree, PhD, or PharmD preferred.… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …for accurate follow-up of claims. Ability to perform complicated calculations to adjudicate accounts appropriately. Ability to analyze & adjudicate contractual ... arrangements as determined by agreements entered into by the Medical Practive Foundation. Reviews remittance codes from EOB-s & R/A-s to ensure payment or to identify denials or non-payment. Responsible for follow up with payor on the routing of claims. Refers… more
- Deloitte (Columbus, OH)
- …and strategize on key graphics + Create and update graphics + Adjudicate /mitigate conflicts in design content + Ensure accuracy and currency of published ... graphics, QA all graphics + Demonstrate the ability to think creatively and express ideas orally and in writing + Have active listening and decision-making skills + Manage document formatting using Macro-enabled templates; update Macro-enabled Word templates… more
- Sedgwick (Columbus, OH)
- …driven to deliver great work. + Apply your adjuster knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver ... innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. + Take advantage of a variety of professional development opportunities that help you perform your best work,… more
- Sedgwick (Columbus, OH)
- …of the world's best brands? + Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver ... innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer… more
- Sedgwick (Columbus, OH)
- …of the world's best brands? + Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver ... innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer… more
- Option Care Health (Columbus, OH)
- …form. Reports must be processed for meaningful interpretation by others. + Adjudicate all disputes over marketing territories that may arise, from time-to-time ... amongst team. + Responsible for hiring/firing/employee discipline/annual performance reviews of all staff. + Distribute marketing material to all types of clients and will act as a resource regarding current market conditions and information gathered in the… more
- Randstad US (Dublin, OH)
- …and making telephone/video calls + Correspond with clients via email interactions + Adjudicate property settlements or denials up to a certain authority + Document ... notes for each open case until it is closed Skills + Brazilian Portuguese (5 years of experience is required) + Investigative Minded + Billing + Detail oriented + Math and Calculation (2 years of experience is required) + Phone Etiquette + Communication +… more
- Defense Commissary Agency (NY)
- …4 copy is preferred as it contains key information necessary to adjudicate your claimed preference. DD-214 Worksheets are not acceptable documentation, nor are ... other than a member 4 copy to which a member 4 Character of Service section is added. Contact the National Archives or your military personnel records center to request a copy of your DD-214. Current active duty armed forces personnel within 120 days of… more
- Robert Half Office Team (Spokane, WA)
- …dealing with Consumer Driven Health Care (CDH) Clerical Services. Responsibilities: + Adjudicate claims received via email, mail, fax, online, or in-person. + Review ... the claim in the system if received electronically, or on paper if received through manual submission for expenses to validate if they are IRS eligible expenses for reimbursement or not. + Answer client and participant inquiries received via phone, email,… more
- Banner Health (AZ)
- …out-of-pocket expenses, and payments via telephone or in writing. Verifies adjudicate claim payments independently and in accordance with plan guidelines. Performs ... analysis and appropriate follow-up while working with many individuals to acquire necessary materials and information, including, but not limited to: physicians, facility staff, professional staff and physicians' office staff. 4. Identifies and resolves… more
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