• Patient Account Representative

    Guidehouse (Lewisville, TX)
    …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative ** is an extension of a client's business ... **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS 1500… more
    Guidehouse (02/02/25)
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  • PAR - Claims Representative II

    Medical Mutual of Ohio (Toledo, OH)
    …Experience:** + High School diploma or GED + 2 years of experience as a Claims Representative in health insurance operation or equivalent experience with ... Knowledge of data entry and standard office procedures + Knowledge of health insurance claims processing and provider coding + Alpha-numeric keyboarding skills… more
    Medical Mutual of Ohio (03/04/25)
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  • Claims Representative Workers…

    Sedgwick (Ontario, CA)
    …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative Workers Compensation **PRIMARY PURPOSE** : To analyze ... not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to… more
    Sedgwick (01/09/25)
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  • Industry Advancement Program | Workers…

    Sedgwick (Brea, CA)
    …Workplace(R) Forbes Best-in-State Employer Industry Advancement Program | Workers Compensation Claims Representative Trainee | (In-Office) **PRIMARY PURPOSE** : ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
    Sedgwick (03/07/25)
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  • Claims Representative - Workers…

    Sedgwick (Naperville, IL)
    …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Workers Compensation - Naperville, IL - Hybrid ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
    Sedgwick (03/05/25)
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  • Pharmacy Claims Representative

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims adjudication to support ... up and maintaining hospice/facility/pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support Services)… more
    Humana (03/08/25)
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  • Medicare Collections Representative

    UCLA Health (Los Angeles, CA)
    Description As a Medicare Collections Representative , you will manage a designated portfolio of inpatient and outpatient claims , ensuring effective and ... up on claims to ensure timely resolution. + Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve… more
    UCLA Health (01/31/25)
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  • Medical Billing & Claims

    Robert Half Accountemps (Olathe, KS)
    Description We are in search of a Medical Billing & Claims Representative to join our team based in Olathe, Kansas. As part of this role, you will handle various ... tasks related to medical billing, claims , and collections. You will also be tasked with...tasks * Handle Medicaid Billing, Medical Billing, and Medical Insurance Billing operations * Manage Medicare Billing,… more
    Robert Half Accountemps (02/05/25)
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  • Medicare Collections Representative

    Owens & Minor (Indianapolis, IN)
    …reimbursement **JOB SUMMARY** The collections representative follows-up with insurance companies to resolve unpaid claims . Shift: **_M-F 6:30am-8:30am ... teammates. Owens & Minor teammate benefits include: + Medical, dental, and vision insurance , available on first working day + 401(k), eligibility after one year of… more
    Owens & Minor (02/13/25)
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  • Patient Account Representative - Hospital…

    Guidehouse (El Segundo, CA)
    …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative - Hospital A/R Emphasis** is an extension ... three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials +... + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service… more
    Guidehouse (02/08/25)
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  • Billing Follow Up Medicare

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …(Palmetto GBA) and CMS web sites + Understanding of the CMS Publication: 100-4 ( Medicare Claims Processing Manual) + Ensures claim information is complete and ... The Medicare Billing and Follow-up Representative are...limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both… more
    Chesapeake Regional Healthcare (03/04/25)
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  • Payment Posting Representative -I (Medical…

    Trinity Health (Farmington Hills, MI)
    …the banking industry or a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, ... performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities or an equivalent combination of education… more
    Trinity Health (03/07/25)
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  • Regional Claims Specialist (I/II/Sr.)

    NJM Insurance (Trenton, NJ)
    NJM's Workers' Compensation Claims Team is seeking a Regional Claims Specialist (I/II/Sr.). This is a full-time position and offers a hybrid schedule after ... training. The Regional Claims Specialist will be responsible for contacting all parties...1 -3 years' experience as a Workers' Comp Claim Representative , or comparable knowledge and experience with various aspects… more
    NJM Insurance (01/28/25)
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  • Medicare Advantage Quality Consultant…

    Highmark Health (Dover, DE)
    …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
    Highmark Health (03/05/25)
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  • Service / Claims Rep FEP / OPEIU

    Highmark Health (Albany, NY)
    …to inquires from subscribers, members and providers; keys, processes and adjusts claims in accordance with the Service Benefit plan (Federal Employee contract. This ... with Marketing and Enrollment staff and other internal and external entities, including Medicare and Dept of Treasury, to resolve and respond to timely Medicare more
    Highmark Health (03/07/25)
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  • Medicare Documentation Specialist

    Owens & Minor (Tallahassee, FL)
    …teammates. Owens & Minor teammate benefits include: + Medical, dental, and vision insurance , available on first working day + 401(k), eligibility after one year of ... Employee stock purchase plan + Tuition reimbursement **POSITION SUMMARY:** This representative will be required to request Medical documentation and assure received… more
    Owens & Minor (03/08/25)
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  • Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    …of Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product ... Claims Auditor 75 Vanderbilt Ave, Staten Island, NY...PHYSICAL REQUIREMENTS : The physical requirements described here are representative of those that must be met by an… more
    Centers Plan for Healthy Living (03/04/25)
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  • Sr. Workers' Compensation Claim…

    Travelers Insurance Company (Diamond Bar, CA)
    …2 days per week at home. Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to ... resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
    Travelers Insurance Company (03/04/25)
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  • Experienced Workers Compensation Claim…

    Travelers Insurance Company (Richmond, VA)
    …**Target Openings** 2 **What Is the Opportunity?** Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
    Travelers Insurance Company (02/15/25)
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  • Patient Account Representative - Billing…

    Surgery Care Affiliates (Boise, ID)
    …& Accounts Receivable: + Bill and re-bill primary, secondary, and tertiary insurance claims daily. + Maintain knowledge of third-party billing requirements ... by working with insurance providers to resolve issues. + Denials and Claims : + Handle denials and corrected claims independently and collaborate with billing… more
    Surgery Care Affiliates (03/05/25)
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