- AssistRx (Phoenix, AZ)
- The Copay Support/ Claims Processing Specialist is a critical role within the organization and is responsible for servicing inbound calls, EOB faxes, and mail ... Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication,...care or health care providers that meet the program business rules for determination of approval, denial, or pending… more
- Providence (Mission Hills, CA)
- …Human Resources **Job Schedule:** Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE ... functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. +… more
- Kelly Services (Honolulu, HI)
- **NOW HIRING: Temp-to-Hire Claims Specialist - Dental Agency (Honolulu, HI)** **Now Hiring: Claims Specialist ** **Location:** Honolulu, Hawaii **Pay ... Join a reputable dental agency in Honolulu as a Claims Specialist ! Under the supervision of the...High School Diploma required; post-high school training in data processing , office management, business , or a related… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- …perspective and experience makes ConnectiveRx better than the sum of its parts. The Claims Specialist , under the direction of the Supervisor (with guidance from ... Consult with the Team Lead or Supervisor for complex claims or clarification of business rules. Obtains...Health care or pharmaceutical experience, particularly in a medical claims processing , billing provider, or insurance environment… 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 ... in being a key component in the growth and success of our policyholders' business operations. To meet these expectations, WC Claims Specialists are supported by… more
- Sedgwick (San Antonio, TX)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist , Veterinary Claims | Professional Liability | Remote ... preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management… more
- Sedgwick (Los Angeles, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist , Medical Malpractice | Professional Liability | California **PRIMARY ... preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management… more
- Sedgwick (Houston, TX)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist , E&O, D&O | Professional Liabilty **ESSENTIAL FUNCTIONS and ... RESPONSIBILITIES** + Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on… more
- Cedars-Sinai (Los Angeles, CA)
- …environment that fuels innovation. **Req ID** : 13216 **Working Title** : Revenue Cycle Specialist III (PB Claims ) **Department** : CSRC PB - Group 3 CSMCF ... Hospitals! **What will I be doing in this role?** The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and… more
- Mass Markets (Killeen, TX)
- …Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, ... POSITION OVERVIEW MCI is one of the fastest-growing tech-enabled business services companies in the USA, with a strong call center footprint and operations that… more
- Commonwealth Care Alliance (Boston, MA)
- …Revenue Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** ... (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment methodologies +… more
- CVS Health (Franklin, TN)
- …each and every day. **Position Summary** This role will have a focus on training Claims processing and Claims Call Center staff for all products including ... in scope of this role, to support the overall business as needed. This position also: + Holds accountability...three (2-3) years of experience and understanding of Medicare claims processing and/or Healthcare claims … more
- Pacific Medical Centers (Renton, WA)
- … Business Administration. + 2 years in Managed Care operations. + 1 year of Claims processing experience, in a TPA, MSO, HMO, PHO or large group practice ... for PMC's enrolled capitated population and communicates those actions. Adjusts complex claims for advanced processing needs. Responds to Customer Service… more
- Modernizing Medicine (FL)
- …for all inbound and outbound patient calls regarding patient balance inquiries, claims processing , insurance updates, and payment collections + Initiate outbound ... positive impact on healthcare. Join Us! + South Florida Business Journal, Best Places to Work 2024 + Inc....Germany. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping… more
- CGI Technologies and Solutions, Inc. (Nashville, TN)
- ** Business Processing Specialist ** **Category:** Administration **Main location:** United States, Tennessee, Nashville **Position ID:** J1125-1445 ... provision of affordable housing has an opening for a Business Processing Specialist in Nashville,...determining their annual rent adjustments, reconciling monthly payment requests, processing claims for unpaid rent and damages… more
- Truist (Orlando, FL)
- …guidelines. 2. Independently analyze, research, and support electronic payment cases/ claims /inquiries escalated by internal departments and client service centers to ... resolution. Claims /inquiries related to Regulation E are met in accordance...provide internal departments with appropriate payment channel/solution to meet client/ business needs while mitigating associated risk. 7. Maintain extensive… more
- Adecco US, Inc. (Jacksonville, FL)
- …line of business preferred. . Experience Five (5) years of claims management experience or equivalent combination of education and experience required. . Skills ... Adecco is assisting a local client recruiting for ** Claims Examiner** opportunities **Remote** . This is an...professional and timely manner. . Communicates claim activity and processing with the claimant and the client; maintains professional… more
- Adecco US, Inc. (Washington, DC)
- …line of business preferred. . Experience Five (5) years of claims management experience or equivalent combination of education and experience required. **Skills ... Adecco is assisting a local client recruiting for ** Claims Examiner Workers Compensation** opportunities in **Remote** . This is an excellent opportunity to join a… more
- Dignity Health (Bakersfield, CA)
- …of complex healthcare claims . This position requires expert knowledge of claims processing , coding, and regulatory compliance. The Claims Examiner ... **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years...+ Associate's Degree - Associate's Degree in healthcare administration, business , or related field preference or experience in lieu… more
- Ventura County (Ventura, CA)
- …general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance ... years + 5 or more years 02 Describe your experience with billing and processing claims for timely reimbursement and compliance with Medi-Cal, Medicare, and… more
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