- 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
- CVS Health (Scottsdale, AZ)
- …-Working within turnaround times to meet client performance guarantees for claims processing . -Meeting productivity and accuracy standards **Required ... include: -Outbound calls to Members and/or Providers for verification of information - Processing and adjudicating paper claims . -Maintaining integrity of … more
- Access Dubuque (Dubuque, IA)
- Claims Processing Representative **Grand River Medical Group** 1 Positions ID: 1384666 Posted On 12/23/2024 **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
- Humana (San Juan, PR)
- …part of our caring community and help us put health first** The Supervisor, Claims Processing reviews and adjudicates complex or specialty claims , submitted ... either via paper or electronically. The Supervisor, Claims Processing works within thorough, prescribed guidelines and procedures; uses independent judgment… more
- IQVIA (Atlanta, GA)
- **Experienced Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team. In this position, you… more
- CVS Health (Tualatin, OR)
- …The 340B Sr. Claim Processor is responsible for optimizing the 340B program revenue for CVS Specialty/Coram Pharmacies, by working with those department, as well as ... senior management. They will also be responsible for managing the liaison between CVS Specialty Departments and Wellpartner to ensure projects related to revenue are being completed effectively and efficiently. **Required Qualifications** Bachelor's Degree or… 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
- LA Care Health Plan (Los Angeles, CA)
- …and delegated claims per regulatory and contractual guidelines, which includes: * Processing claims for all lines of business, including complex claims ... providers. (5%) Work with internal departments to resolve issues preventing claims processing or enhancing processing capabilities. May assist in testing,… more
- Banner Health (AZ)
- **Primary City/State:** Arizona, Arizona **Department Name:** Claims Processing **Work Shift:** Day **Job Category:** Administrative Services A rewarding career ... Health Plans Claims Educator, you will leverage your expertise in Medical Claims Processing to enhance and expand the knowledge of the Banner Health Plans … more
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- …(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
- Dignity Health (Bakersfield, CA)
- … Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves ... **Minimum Qualifications:** + Minimum of 5 years of experience in claims processing , quality assurance, or a related role within a managed care… more
- Crawford & Company (Boston, MA)
- …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
- AON (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
- Healthfirst (CO)
- …benefits, claims editing, reference data and system functionality within the claims processing system. + Analyze explanation of coverage documents to assist ... (CPT4, ICD9 or ICD10, and HCPCS), provider contract concepts and common claims processing /resolution practices. + Previous managed care/health plan experience in… 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
- University of Utah Health (Murray, UT)
- …to perform the essential functions of the job as outlined above. + Experience with claims processing in a health care delivery setting or insurance payer. + ... candidate's primary role will be auditing inbound customer service calls. + Claims processing knowledge in a health care delivery or insurance payer setting. +… more
- CenterLight Health System (Flushing, NY)
- …Subrogation conditions + Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor + Attends JOC meetings with providers as ... by creating and testing compensation grids used for reimbursement and claims processing + Ensures that refund checks are logged and processed, enabling… more
- LA Care Health Plan (Los Angeles, CA)
- …This position is responsible for providing ongoing training on the core processing system, claims processing procedures, communicating regulatory changes ... of Managed Care experience. A minimum of 3 years of Medi-Cal and Medicare claims processing or auditing experience. A minimum of 3 years of experience in design… more
- HomeSafe Alliance (Columbus, OH)
- …trends and performance. + Identify and resolve challenges and issues related to claims processing . + Perform other duties as assigned **Qualifications:** + ... **Title:** Claims Manager (HHG/Military Move) **_HomeSafe Alliance_** is the...personal information or money to pay for visa applications, processing fees, etc., in exchange for consideration for a… more
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