- Providence (WA)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, Evaluate, and Manage Professional, ... Program:** + Communicate with patients, claimants, caregivers, providers, leadership + Review and analyze medical records, interview witnesses, assist with… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...adjudication, clinical coding reviews for claims , settlement, claims auditing and/or utilization review required +… more
- TEKsystems (St. Louis, MO)
- …accurately, and pleasantly. Uphold the mindset of working together as a team. * Review and analyze medical claims for eligibility and benefits. * ... Medical Claims Processor Full-Time Opportunity Available... Medical Claims Processor Full-Time Opportunity Available TEKsystems is looking...is looking for someone to join a team of medical claims processors who advocate for members… more
- Robert Half Accountemps (Plantation, FL)
- Description We are offering a short term contract employment opportunity for a Medical Claims Analyst in the insurance industry, based in Plantation, Florida. ... evaluation, and resolution in compliance with company policies * Review claims to ascertain their validity, completeness,...* Proven track record in auditing, ideally in the medical claims field * Knowledge of benefit… more
- Insight Global (Los Angeles, CA)
- … Health Insurance Plan based in Los Angeles is in the immediate need of a Medical Claims Representative. The Medical Claims Representative will be ... with members over the phone and troubleshooting any of the participants bills or claims . The Medical Claims Representative will be tasked with answering… more
- TEKsystems (St. Louis, MO)
- …accurately, and pleasantly. Uphold the mindset of working together as a team. + Review and analyze medical claims for eligibility and benefits. + ... Teksystems is currently looking for someone to join a team of medical claims processors who advocate for the Fund's members while maintaining the policies and… more
- Robert Half Accountemps (Los Angeles, CA)
- Description We are offering a contract to permanent employment opportunity for a Medical Claims Review Coordinator in Los Angeles, California. The individual ... examiners to use in evaluating whether certain types of claims may require review . * Work collaboratively...Provide guidance to Participant Services Representatives on calls regarding medical claims issues. * Recommend changes to… more
- CVS Health (Albany, NY)
- …resource materials to manage job responsibilities. **Required Qualifications** + 2+ years medical claims processing experience. + Experience in a production ... Review and adjust SF, FI, Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims ...claims processing experience. + Reinsurance / Stop loss medical claims experience. + Familiarity with overpayments.… more
- Insight Global (Somerset, NJ)
- Job Description Insight Global is looking for a Medical Claims Biller for one of our healthcare clients in Somerset, NJ. The candidate will oversee calculating ... reimbursed for the specific healthcare service provided. They must have experience following medical claims and updating patient data. The candidate should also… more
- CVS Health (Greensburg, PA)
- …in the Monroeville area, has an opportunity available for a full time Medical Claims Refund Specialist. This role ensures timely credit balance resolution ... Qualifications** + 1+ years' experience performing health care reimbursement, medical billing or insurance collections, and/or account reconciliation/ account … more
- Randstad US (Dallas, TX)
- …payers, patients, and third-party insurers. + Prepare, submit, and follow up on medical claims using Brightree software. + Account reconciliation for A/R ... medical collections and claims specialist. +... medical collections and claims specialist. + dallas , texas + posted...review reports to track A/R performance and outstanding claims . + Work closely with internal teams such as… more
- Robert Half Accountemps (Lawrenceburg, IN)
- Description We are in search of a Medical Billing/ Claims /Collections professional to join our team based in Southeast, Indiana. This role involves handling and ... and collections. Requirements * Must have 3+ years of experience in Medical Billing/ Claims /Collections * Proficiency in EHR (Electronic Health Records) System… more
- Ascension Health (Jacksonville, FL)
- … claims for submission to third party payers and/or responsible parties. + Review claims for accuracy, including proper diagnosis and procedure codes. + ... Friday 7:30am - 4:00pm + **Facility:** Ascension St. Vincent's Medical Group + **Location:** Jacksonville, FL **_Listening to you,...Review claim rejections and communicates with payers to resolve… more
- Whitney Young Health Center (Watervliet, NY)
- …Apply Description GENERAL RESPONSIBILITIES: Responsible for reviewing medical claims prior to submission and ... service provision, patient case management, follow-up, and billing; Local Medical Review Policies (LMRP) for Medicare and...date . Four (4) years of progressive experience in medical billing and claims processing in a… more
- Crawford & Company (Brea, CA)
- …the processing of the claim. + Identifies wage loss expenses and wage exposures on medical claims . + Documents receipt and contents of medical reports. ... exceeding, $2,500 after compensability has been determined. + Evaluates medical claims for potential fraud issues, loss...carrier guidelines and prepares written updates for supervisor to review . + Performs other related duties as required or… more
- Cedars-Sinai (CA)
- …+ Supports core values, policies, and procedures. + Acquires and adjudicates medical claims for processing; reviews scanned, EDI, or manual documents ... in applicable tracking databases. **Qualifications** **Experience:** Three (3) years of medical claims processing for Medicare and Commercial products and… more
- Sedgwick (Columbus, OH)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Adjuster- Liability **PRIMARY PURPOSE:** To analyze mid- and higher-level general… more
- Sedgwick (Concord, CA)
- …properly documented and claims coding is correct. + May process low-level lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Workers Compensation (On-Site Concord, CA) **PRIMARY PURPOSE** :… more
- Sedgwick (Ontario, CA)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Adjuster Workers Compensation - (Hybrid Schedule) **PRIMARY PURPOSE** **:** To… more
- Access Dubuque (Dubuque, IA)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Claims Adjuster - Liability **Sedgwick** 1 Positions ID:...filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL FUNCTIONS and… more