- Medical Mutual of Ohio (Toledo, OH)
- …Knowledge:** + Knowledge of data entry and standard office procedures + Knowledge of health insurance claims processing and provider coding + Alpha-numeric ... or GED + 2 years of experience as a Claims Representative in health insurance operation or...at a minimum of 6,000 ksph + Proficiency with claims processing systems and basic Microsoft Office… more
- HCA Healthcare (Nashville, TN)
- …The Claims Auditor will serve as a Subject Matter Expert (SME) in medical claims processing at health plan payor, MSO, HMO, and IPA organizations with ... HCA, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...primary function to ensure examiner payment accuracy of all claims processing including analysis of support services… more
- Medical Mutual of Ohio (OH)
- …or PBM, or equivalent experience in healthcare or financial services. . Strong health insurance claims processing and membership systems, database ... Access, and Power BI) skills. . Knowledge of interfacing health plan data, including membership and claims ,...(PBM) company. . Knowledge of PBM benefits set up, claims processing , and related regulatory requirements. .… more
- Elevance Health (Houston, TX)
- …The ** Claims Representative II ( Health & Dental)** is responsible for keying, processing and/or adjusting health claims in accordance with claims ... ** Claims Representative II ( Health & Dental)** **Must be located within 50 miles of Norfolk, VA, Tampa, FL, Houston, TX or Mason, OH.**… more
- AdventHealth (Maitland, FL)
- … claims analytics strongly preferred. + Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical ... Repayment Program - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about… more
- Conduent (Helena, MT)
- …with Department of Health and Human Services personnel concerning claims processing functions. Driving special projects for corporate, operational, or ... fostering efficiency and driving operational success. **Responsibilities** Managing a claims processing department to effectively and efficiently meet… more
- Cardinal Health (Columbus, OH)
- …degree strongly preferred + Knowledge of the specialty drug product marketplace, health insurance claims processing , and commercialization of products ... the leading provider of comprehensive pharmaceutical commercialization services, Sonexus Health empowers pharmaceutical manufacturers by integrating innovative distribution models… more
- CVS Health (Scottsdale, AZ)
- …-Working within turnaround times to meet client performance guarantees for claims processing . -Meeting productivity and accuracy standards **Required ... Bring your heart to CVS Health . Every one of us at CVS ...calls to Members and/or Providers for verification of information - Processing and adjudicating paper claims . -Maintaining integrity… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Health . **Essential Job Functions** + Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for ... . + Coordinates periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality… more
- Fallon Health (Worcester, MA)
- …least 1 - 2 years of managing direct reports + Experience working in health insurance specifically with claims processing , billing, reimbursement, coding, or ... investigations, mitigate risk, and capture results. + 5-8 years of related health care claims auditing experience in a complex healthcare environment, with at… more
- CGI Technologies and Solutions, Inc. (Albany, NY)
- **Business Claims Processing Specialist** **Category:** Administration **Main location:** United States, New York, Albany **Position ID:** J1024-0536 ... of affordable housing has an opening for a Business Claims Processing Specialist in Albany, NY. This...You'll be supported by leaders who care about your health and well-being and provide you with opportunities to… 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 ... experience. + 2 years experience in a medical/institutional claims customer services unit within a health ...time **Job Shift:** Day **Career Track:** Leadership **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Billing/ Claims Processing + **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM + **Hospital:** Ascension St. Vincent + **Location:** ... Onsite in Jacksonville, FL **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
- Liberty IT Solutions, LLC (Boston, MA)
- …Knowledge of EDI file types: X12, XML, JSON, NCPDP, and flat files Knowledge of health claims processing Vetting: Applicants selected will be subject to a ... government investigation and may need to meet eligibility requirements of the US government client. ThunderYard Solutions is proud to be an Equal Opportunity Employer. We don't just accept difference - we celebrate it, we support it, and we thrive on it for… more
- Army National Guard Units (Lincoln, NE)
- …Program, MOS Medical Review Board (MMRB) Program, Medical Disqualification Program, Follow up Health Care Program, Medical Claims Processing Program, Medical ... Summary This National Guard position is for a HEALTH SYSTEM SPECIALIST, Position Description Number D1119000 and is part of the 1-376th AVN Regiment, Nebraska Army… more
- Veterans Affairs, Veterans Health Administration (Denver, CO)
- Summary This position is in the Beneficiary Claims Processing Unit, CHAMPVA program, 3.1 Network Development and Operations, Integrated External Networks, ... Examiner reports to the Supervisor of the Beneficiary Claims Processing Unit. The primary function of...data, medical audits such as for ambulance, dental, mental health services, durable medical equipment (DME), and medical care… more
- Fallon Health (Worcester, MA)
- …complex and high dollar claims . + Ensures accuracy and timeliness of claims processing to minimize late payment interest penalties and ensure compliance with ... and 2 days working at home.** **About us:** Fallon Health is a company that cares. We prioritize our...Facebook, Twitter and LinkedIn. **Brief Summary of purpose:** The Claims Examiner should have thorough claim processing … more
- Kestra Financial (Deerfield, IL)
- …insurance, and even health insurance benefits. DUTIES AND RESPONSIBILITIES + Health Insurance administration and claims processing . + Basic ... appropriately and according to firm guidelines. + Manage client needs regarding processing , servicing, and problem resolution in a timely and accurate manner. +… more
- Martin's Point Health Care (Portland, ME)
- …Summary Job Description Position Summary: Under the supervision of the Director of Health Plan Operations, the Claims Auditor II will perform the following ... Join Martin's Point Health Care - an innovative, not-for-profit health...Support of auditors, regarding audit development activities and audit processing . + Perform claims audits to identify… more
- Highmark Health (Pittsburgh, PA)
- …**systems and technology** **will be essential.** **This includes k** nowledge of claims processing platforms, data management systems, and relevant technologies ... the Delivery team. **A d** **eep understanding of the health ** **insurance** ** claims process** **will be essential**...like AI/ML to optimize claims processing . **ESSENTIAL RESPONSIBILITIES** + Understand the… more
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