- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred… more
- Commonwealth Care Alliance (Boston, MA)
- …certifications **Required Experience (must have):** + 3+ years in healthcare claims processing , provider reimbursement, or payment integrity. + Experience ... have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or...+ Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid… more
- AmeriHealth Caritas (Charleston, SC)
- …education and experience preferred. + Required ability to focus on technical claims processing and Provider data maintenance knowledge. + Required understanding ... Configuration Department. + Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy and operational procedures to… more
- Humana (St. Paul, MN)
- …documentation and communications. + Exceptional attention to detail and accuracy in reviewing and processing claims . + Ability to quickly adapt to and learn new ... opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent...systems and technologies relevant to claims processing . + Strong organizational skills with… more
- Humana (San Juan, PR)
- …assistance. See _Additional Information_ on testing. **Preferred Qualifications** + Prior claims processing experience. + Knowledge of healthcare terminology. ... first** Join Humana's dynamic Puerto Rico team as a Claims Research & Resolution Representative and make a meaningful...90 days of employment. **Language Proficiency Testing** Any Humana associate who speaks with a member in a language… 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...of CPT, ICD-10, HCPCS coding, and medical terminology. + Associate 's Degree - Associate 's Degree in healthcare… more
- Sanford Health (SD)
- …- $23.00 **Department Details** WFH Day 1 **Job Summary** The Associate Insurance Representative processes and monitors unpaid third party insurance, Medicare, ... Medicaid or government-assisted program accounts for proper reimbursement; primarily...but not limited to prebilled accounts. Prepares and submits claims to payers either electronically or by paper. Secures… more
- KPH Healthcare Services, Inc. (Rochester, NY)
- …Care, and private billing, claim corrections and follow-up + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems ... **Overview** **Scope of Responsibilities** : The Administration Billing Associate is responsible for identifying, researching, rectifying, and maintaining accurate… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims . + Participates in the development and implementation of TPL ... systems and policy. + Minimum 2 years professional experience with liability insurance claims processing . + Minimum 1 year professional experience with CPT,… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Associate Director, Revenue Cycle Management (RCM) Optimization manages and organizes revenue strategy ... in this role assists with the strategic alignment and oversight of claims assembly and submission processes. In close collaboration with Billing, Coding, IT,… more
- Caris Life Sciences (Irving, TX)
- …accurate, follow up on requests, and apply acquired knowledge of Medicare, Medicaid , and other Third-Party Payer requirements **Job Responsibilities** + Adheres to ... needed to complete coverage verification. + Verifies insurance eligibility to ensure claims are billed accurately and in accordance to payer guidelines. + Ensures… more
- Albany Medical Center (Albany, NY)
- …school education or equivalent + 1-2 years of experience in medical billing or medical claims processing + Working knowledge in Excel and Word + Ability to work ... credits - Complete daily review of patient accounts that are pending NYS Medicaid and/or Charity Care status - Complete monthly rejections categorized as eligibility… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... billing and processing program claims for accuracy and completeness; submit claims ...+ Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid , Medicaid Managed Care and other payers'… more
- Clark County, NV (Las Vegas, NV)
- … MEDICAID : QUESTIONS 31-36 Indicate your full-time professional experience with Medicaid billing, claims management, or reconciliation in a clinical, ... Analyst. This position will support the Fiscal, Grants, Contracts, and Medicaid program operations. These supervisory positions provide leadership and oversight in… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE CLERICAL ASSOCIATE CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE ... from the Social Security Administration for SN/SSI clients and SSP refunds and Medicaid Spend Down program payments. DARB is responsible for the collections, refunds… 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- Humana (Lincoln, NE)
- …+ Develop and recommend controls and cost-effective approaches to minimize claims processing risks. + Will perform advanced administrative/operational/customer ... professional and institutional claims reimbursement + Strong knowledge of TRICARE policy and claims processing + Able to work 8 hour shift between the hours… more
- Humana (Oklahoma City, OK)
- …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Assist in developing FWA education to ... of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development +… more
- MyFlorida (Tallahassee, FL)
- …well as engage in other prevention activities, including pre-payment reviews, paid claims reversals, site visits, identifying and processing sanctions of ... will support the fraud and abuse prevention efforts within the Bureau of Medicaid Program Integrity (MPI). MPI is organized by the functions that fall within… more