- Fedcap (South Portland, ME)
- …detail oriented, and adaptable finance professional to join our team as a Claims Specialist ! The hired person will partner with finance supervisors, managers, ... training, professional development, and REAL advancement opportunities! Position Summary: The Claims Specialist is responsible for carrying out financial… more
- UNUM (Portland, ME)
- …candidates to fill various roles related to managing leave requests and disability claims . When you apply, you'll be considered for positions such as Integrated Paid ... Leave Specialist , STD Benefits ...+ Handle leave, short-term disability (STD), or paid leave claims efficiently and accurately. + Determine if employees are… more
- UNUM (Portland, ME)
- …an assigned caseload, while exercising discretion and independent judgment. The Benefit Specialist Trainee should provide timely claims decisions and strong ... is on-site at our Portland, Maine home office location** As a Benefit Specialist Trainee, you are primarily responsible for learning and developing the essential… more
- Martin's Point Health Care (Portland, ME)
- …appeals management process. Job Description Key Outcomes: + For Medicare Focused Specialist : + Researches, processes and resolves Part C reconsiderations with 100% ... for Part C appeals Medicare Managed Care Manuals + For USFHP Focused Specialist : + Researches, processes and resolves all appeals in accordance with Tricare and… more
- Martin's Point Health Care (Portland, ME)
- … claims processing and health plan benefits necessary for the Appeals Specialist to exercise decision-making authority to reprocess claims in accordance and ... Independently and with judgement, conducts multi-faceted, complex investigations through claims review, provider credentialing, authorization processing, timeliness evaluations, and… more
- Walgreens (Bath, ME)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Dairy Farmers of America (Portland, ME)
- …and submit necessary information for motor vehicle and property damage incident claims . Assist the transportation management team by managing online hiring platforms ... and screening applicants for employment. Coordinate with vendor installation and service to delivery equipment. **Duties and Responsibilities:** + Provide administrative support functions relating to safety, compliance, productivity and transportation… more
- ProTrain (Portland, ME)
- …+ Live Online instructor + Describe the role of the Certified Medical Billing Specialist + Describe the origin of medical language. + Analyze the component parts of ... the responsibilities assigned to insurance billing and coding specialists and electronic claims processors. + Describe the health care delivery system. + Explain the… more
- Elevance Health (South Portland, ME)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more