- 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
- Sedgwick (Ontario, CA)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative Workers Compensation - (Hybrid Schedule) **PRIMARY PURPOSE** ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Point32Health (Canton, MA)
- …the general direction of the Call Center Supervisor, the Member Services Representative is responsible for providing accurate and thorough interpretation of Tufts ... Health Plan (Tufts HP) benefits, claims processes, eligibility, and enrollment policies to members, employers, and internal customers. In addition, the Member… more
- CVS Health (Columbus, OH)
- …of business - Working rework reports timely - Researching and troubleshooting failed claims - Adding and/or editing overrides in RxClaim - Logging audits and errors ... Determination & Appeals experience. - 1 plus year of Medicare PART B experience - MHK, RxClaim, and People...eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long… more
- Banner Health (Mesa, AZ)
- …If you're looking to leverage your abilities - you belong at Banner Health. The Claims Follow Up PFS Representative CBO will be responsible for verification of ... eligibility and work edits on claims that are preventing claim from releasing, rejecting. Systems frequently used: MS4, Cerner, Finthrive claims and collections,… more
- BrightSpring Health Services (Arlington, TX)
- …obtaining information, completing necessary documentation, and following up on outstanding claims . + Understands Insurance and Medicaid formularies and ... schedules Competitive pay Shift differential Health, dental, vision and life insurance benefits Company paid STD and LTD Tuition Assistance Employee Discount… more
- TEKsystems (Green Bay, WI)
- Medical insurance experts needed! Please apply! This position is responsible to apply knowledge of the company's business, products, members and operations to ... eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims , payments, member reimbursement, and demonstrated knowledge of CAG policies,… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking a Regional Claims Specialist. This is a full-time position and offers a hybrid schedule after training. The ... Regional Claims Specialist will be responsible for contacting all parties...- 3-5 years' experience as a Workers' Comp Claim Representative , or comparable knowledge and experience with various aspects… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …or equivalent required **Work Experience** + 6 months of experience in medical claims or health insurance -related customer service or the successful completion ... Duties may include the following responsibilities or functions required to support the claims unit. Accurate processing of claims edits, determining primacy for… more
- Access Dubuque (Dubuque, IA)
- …Auto Site Scanner Tech - Catastrophe Repair Soluti Sedgwick Commercial Auto Claims Representative - Liability Sedgwick **Share this Job** Sedgwick **About ... Auto Liability Bodily Injury Claims Examiner **Sedgwick** 1 Positions ID: R52610 Posted...+ Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles,… more
- Adecco US, Inc. (Roseville, CA)
- …or equivalent combination of education and experience or successful completion of Claims Representative training required. Skills & Knowledge * Developing ... one of their top clients with their search to fill a Workers Comp Claims Processor role in California! $45/hr Remote * Processes low level workers compensation … more
- 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
- 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 (Alpharetta, GA)
- …**Target Openings** 1 **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
- Sanford Health (Fargo, ND)
- …Insurance Representative processes and monitors unpaid third party insurance , Medicare , Medicaid or government-assisted program accounts for proper ... Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and...desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal… more
- Travelers Insurance Company (Federal Way, WA)
- …Is the Opportunity?** Applicants who are licensed to handle Workers Compensation Claims in Washington state are strongly preferred. The selected candidate must ... supervision, effectively evaluate and manage high exposure Workers Compensation claims including catastrophic loss, specified serious injury and other complex… more
- 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
- Travelers Insurance Company (Overland Park, KS)
- …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
- Surgery Care Affiliates (Phoenix, AZ)
- …for Primary insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or ... guidelines and the process of collecting over the counter payments/deductibles/copay/co- insurance . Knowledge of payer contracts including Medicare , Medicaid… more
- Humana (Indianapolis, IN)
- …Healthy Horizons in Indiana is seeking a Provider Education & Outreach Representative who is responsible for the day-to-day front line relationship management of ... and resolving issues or complaints. The Provider Education & Outreach Representative will specialize in supporting Long-Term Services and Supports (LTSS) and… more
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