- Molina Healthcare (Columbus, OH)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- CenterWell (Jefferson City, MO)
- …+ High School Diploma or the equivalent + Minimum of two years medical claims processing experience preferred + Knowledge of healthcare collection procedures and ... agencies, and the timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate… more
- Molina Healthcare (MI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to… more
- Molina Healthcare (Columbus, OH)
- …remediation plans and fixes, overall progress, and status of impacted claims **JOB QUALIFICATIONS** **Required Education** Associate 's Degree or equivalent ... **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing requirements (1500 and UB04), provider and benefit… more
- Molina Healthcare (Long Beach, CA)
- …advanced Excel or SQL. + Must be able to conduct root cause analysis in Healthcare Porvider claims data.. + Experienced in Healthcare domain specifically ... HS Diploma or GED **Required Experience** 0-1 year **Preferred Education** Associate degree or equivalent combination of education and experience **Preferred… more
- Humana (Green Bay, WI)
- …a part of our caring community and help us put health first** The Claims Research & Resolution Representative 3 manages claims operations that involve customer ... contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The … more
- Providence (OR)
- …in Salem, Oregon **Required Qualifications:** + 1 year - Experience in a Associate Claims Specialist position **Preferred Qualifications:** + Bachelor's Degree + ... 1 year of experience with healthcare customer service and/or claims , accounting **Why Join Providence Health Plan?** **Our** **best-in-class benefits** **are… more
- University of Utah Health (Murray, UT)
- …that are integral to our mission. EO/AA_ + This position is responsible for auditing claims and customer service calls for UUHP. + The Claims and Customer ... Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1...Performs routine and complex audits on phone calls and claims adjudication. + Researches claim processing problems and errors… more
- UPMC (Pittsburgh, PA)
- **Purpose:** The function of the Associate Accounts Receivable Claims Analyst is to ensure all HRA, FSA , ASO & Stop Loss related reporting & reconciliation, ... claims utilization billing, and employer group reimbursements are completed...related field preferred + Minimum of 1 year of healthcare , insurance, or other financial experience required + Demonstrate… more
- Humana (San Juan, PR)
- …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 requiring… more
- Kelly Services (Glastonbury, CT)
- **Now Hiring: Claims Specialist - Medical Claims (Bilingual)** **Position:** Claims Specialist - Medical Claims (Bilingual) **Salary:** $22 - $23/Hour ... Spanish Speaking **Job Summary:** We are seeking a dedicated and detail-oriented Claims Specialist to join our fast-paced environment. The ideal candidate will have… more
- Hackensack Meridian Health (Eatontown, NJ)
- …community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. Responsible for long-term care ... the pharmacy operations team to ensure timely submission and resolution of prescription claims . **Responsibilities** A day in the life of a Pharmacy Claims … more
- UNUM (Chattanooga, TN)
- …candidates to fill various roles related to managing leave requests and disability claims . When you apply, you'll be considered for positions such as Integrated Paid ... Leave Specialist, STD Benefits Specialist Trainee, Associate Leave Specialist, Eligibility Specialist and Associate ...+ Handle leave, short-term disability (STD), or paid leave claims efficiently and accurately. + Determine if employees are… more
- DriveTime (Mesa, AZ)
- …which provides quality warranty and ancillary products, and a customer-friendly claims process. SilverRock offers a variety of ancillary products and administrative ... contracts, products, and warranties, and over $300 million in claims . **That's Nice, But What's the Job?** In short,...optimistic attitude. **The Specifics.** + High School diploma required; Associate or Bachelor's deree is preferred + 3 +… more
- Signature Healthcare (Louisville, KY)
- Signature HealthCARE is a family-based healthcare company that offers integrated services in 7 states across the continuum of care: skilled nursing, ... Work for three years in a row and Modern Healthcare 's "Best Places to Work!" This position will be...be limited to: managing administrative (survey) and other legal claims against company; interfacing with outside legal counsel; administering… more
- Ascension Health (Jacksonville, FL)
- …party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review ... claims for accuracy, including proper diagnosis and procedure codes....providing caregivers in every discipline a rewarding career in healthcare since 1873. Ascension is a leading non-profit, faith-based… more
- Humana (Columbus, OH)
- …organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Healthcare Program Associate - Albany, NY** **DMDD - 1317** **Summary** The Division ... Dental Directors, Bureau of Medical Review is recruiting for Healthcare Program Associate to assist the Bureau...assist the Bureau in day-to-day operations for the Pended Claims Unit. The Bureau of Medical Review is responsible… more
- Elevance Health (Plano, TX)
- A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable ... centers, and the home setting. **Job Title:** Pharmacy Customer Associate **Hours:** On-site position; M - F, 9am -...+ Copies incoming and outgoing correspondence. + Ensures rejected claims were denied correctly or determines if those … more
- Grant Thornton (Newport Beach, CA)
- As a Healthcare Process Risk Senior Associate , you will get the opportunity to grow and contribute to our clients' business needs by helping them understand ... The ideal candidate will have exceptional expertise and experience in healthcare providers, specifically hospitals, academic medical centers, and healthcare … more