- Zurich NA (New York, NY)
- Claims Specialist II , General Liability, Dedicated Team 113758 Zurich North America is seeking a skilled Claims Specialist to handle Commercial ... NJ, New York, (WTC). With moderate direction, this position handles multi-party CGL claims of moderate to high exposure and complexity within specific limits of… more
- Penn Medicine (Radnor, PA)
- …**Department: Oral Surgery** **Hours: Full Time, per departmental needs** **Summary:** The Accounts Resolution Specialist II reports to the Supervisor of ... Billing; this individual specializes in the resolution of patient accounts transferred from the PBO. This...denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim… more
- NJM Insurance (Trenton, NJ)
- …Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist . This is a full-time position and offers a hybrid schedule after training. ... an action plan to manage the claim to final resolution . The Complex Claim Specialist will work...manage select Catastrophic (CAT) losses assigned by the Complex Claims Supervisor for developmental purposes. This role can be… more
- Johns Hopkins University (Middle River, MD)
- …process, either electronically or by paper. The AR Revenue Cycle Specialist II will use a comprehensive knowledge of claims submission requirements for all ... II_** responsible for the collection of unpaid third-party claims and resolution of non-standard appeals, using...in order to expedite payments. The AR Revenue Cycle Specialist II will research and interpret medical… more
- AON (Fort Wayne, IN)
- Underwriting Specialist II K&K Insurance is a leading provider of specialty coverage in the exciting areas of sports, leisure, recreation, motorsports and ... choose K&K for our unique insurance products and expert claims resolution . As part of an industry-leading...What the day will look like As an Underwriting Specialist II , you will report directly to… more
- The Toro Company (Bloomington, MN)
- …driven business process role delivering high quality work and process improvement ideas. + Specialist II : 3-5 years of experience in an analytical, data driven ... + Audit, approve, and process rebate and co-op claims in a timely and accurate manner. + Define...the company including sales, credit and marketing for claim resolution . + Offer process improvement suggestions and update process… more
- LA Care Health Plan (Los Angeles, CA)
- Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals Department: Claims Integrity Location: Los ... that purpose. Job Summary The Coordination of Benefits (COB) Validation Specialist ensures the accurate coordination of healthcare benefits for individuals covered… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training...additional service needs according to specific program guidelines. Uses claims processing and care management software to look up… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY * The Revenue Cycle Specialist II will be responsible for the review, minor analysis, trending and follow up of Third Party Claims ... to include the identification, billing and collection of payments. The Revenue Cycle Specialist II will actively engage with other departments to ensure timely… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically necessary… more
- Beth Israel Lahey Health (Burlington, MA)
- …helps to resolve callers' issues, retrieving critical information that impacts the resolution of current or potential future claims . 3. Establishes relationships ... Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and...Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 1-2 years of… more
- Guthrie (Towanda, PA)
- …spreadsheets, creates and runs reports as needed to be used in the resolution of outstanding claims (ex. trending, projects, worklists) Identifies trends and ... Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a...required and requested. Works with insurance payers on problem claims and processes. Resolves outstanding Accounts Receivable and credit… more
- Cedars-Sinai (Torrance, CA)
- …in other revenue cycle functions and provide back-up coverage. The Revenue Cycle Specialist II : + Participates in department meetings and provides feedback to ... and courteous demeanor. **Req ID** : 1194 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business Entity** :… more
- Intrepid USA (Campbellsville, KY)
- …individuals in the Agency in a timely manner. We are looking for an Support Specialist II who is highly organized and detail-oriented with the ability to ... acquisition, recruiting process and team members As a Support Specialist , you will be responsible for non-clinical areas of...as needed + Completing Key Performance Indicators reporting and resolution on a daily basis: . RAPs Reporting .… more
- University of Utah Health (Salt Lake City, UT)
- …and overall patient outcomes. **Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + Performs contract compliance on ... This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts… more
- Cedars-Sinai (Los Angeles, CA)
- …our care the most. **Req ID** : HRC1268782 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business Entity** : ... performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating… more
- Cedars-Sinai (Torrance, CA)
- …Professional and courteous demeanor. **Req ID** : 1640 **Working Title** : Revenue Cycle Specialist II **Department** : CSRC PB - Group **Business Entity** : ... performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating… more
- The Mount Sinai Health System (New York, NY)
- …and problem resolution to ensure accurate and timely payment of claims and collection. Maintains open dialogue with the Department Administrator and/or Revenue ... coding, Accounts Receivable, Charge Entry, Edits and Payment Posting. Facilitates claims processing for services rendered by physicians. Assists with responses to… more
- Centene Corporation (Tallahassee, FL)
- …in maintaining relationships between departments to ensure timely and appropriate issue resolution + Supports the documentation, tracking, and resolution to all ... effective support to customers + In some instances, researches and identifies basic claims payment errors and make appropriate adjustments + Performs other duties as… more
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