• 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 (11/03/24)
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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 (11/02/24)
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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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  • Claims Research & Resolution…

    Humana (Green Bay, WI)
    **Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 3 manages claims operations that ... all claim settlements both for and against the organization. The Claims Research & Resolution Representative 3 performs advanced… more
    Humana (01/18/25)
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  • Workers Compensation Claims

    Sedgwick (Ontario, CA)
    …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Representative | Ontario, CA **PRIMARY PURPOSE** : To process ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
    Sedgwick (01/18/25)
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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 (01/15/25)
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  • Workers Compensation Claims

    Sedgwick (Albany, NY)
    …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Representative | Remote | NY Licensing Required **PRIMARY ... PURPOSE** **:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company… more
    Sedgwick (12/12/24)
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  • Medicare D Billing Representative

    BrightSpring Health Services (Arlington, TX)
    …in obtaining information completing necessary documentation or following up on outstanding claims + Individual with an understanding of Insurance and Medicaid ... 30 days of employment (Health, dental, vision, and life insurance ). + Mileage Reimbursement- We cover your travel costs....as assigned + Achieves productivity goals with regard to calls/ claims per hour as determined by the Director and… more
    BrightSpring Health Services (12/24/24)
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  • Billing Follow Up Medicare

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …(Palmetto GBA) and CMS websites + 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 (12/05/24)
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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 (01/18/25)
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  • Medicare Advantage Quality Consultant…

    Highmark Health (Harrisburg, PA)
    …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 (11/14/24)
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  • Chief Medical Officer, Medicare

    VNS Health (Manhattan, NY)
    …starting at 30 days of paid time off and 9 company holidays + Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability + ... on issues related to Fraud, Waste, and Abuse of Medicare /Medicaid services.* Collaborates with pharmacy services to review PBM...delivery of care and member/provider satisfaction.* Acts as a representative of the VNS Health Plans and an advocate… more
    VNS Health (11/20/24)
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  • Medicare Documentation Specialist

    Owens & Minor (Austin, TX)
    …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 (01/18/25)
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  • Claims Assistant

    Robert Half Office Team (Lakewood, NJ)
    …or mail * Following up on the status of the claim with the Facility Representative or Insurance / Medicare * Intaking the Records request for approval of ... Description We are seeking a Claims Assistant to join our team operating in...professionals, including medical, vision, dental, and life and disability insurance . Hired contract/temporary professionals are also eligible to enroll… more
    Robert Half Office Team (01/14/25)
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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 (12/03/24)
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  • Sr. Workers Compensation Claim…

    Travelers Insurance Company (Overland Park, KS)
    …**What Is the Opportunity?** 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 (12/22/24)
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  • Worker's Compensation Return to Work Claim…

    Travelers Insurance Company (Alpharetta, GA)
    …Potential of up to a $3000 sign on bonus 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 (01/15/25)
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  • Patient Account Representative - Medical…

    Covenant Health Inc. (Knoxville, TN)
    …This position is responsible coordinating daily workflow for accurate submission of insurance claims to payers to ensure timely reimbursement for services ... complex medical claim issues. This position demonstrates the ability to accurately submit claims in all payer categories, ie, Medicare , TennCare, Blue Cross,… more
    Covenant Health Inc. (12/24/24)
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  • Collections Representative

    Spurwink Services (Portland, ME)
    …on denials and outstanding accounts receivable for the agency. Including outstanding Medicare and third-party insurance and miscellaneous billing accounts older ... Representative will also follow up, correct and resubmit claims for all government and non-government denials in a...to Maine Care. + Follow up on all outstanding Medicare , Third Party Insurance , and Miscellaneous Billing… more
    Spurwink Services (12/05/24)
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  • Workers Compensation Claim Representative

    Travelers Insurance Company (Indianapolis, IN)
    …under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and ... Claim team is committed to partnering with our business insurance customers to help their injured employees return to...you will handle all aspects of a workers compensation claims . In this role, you will learn how to… more
    Travelers Insurance Company (01/16/25)
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