- Travelers Insurance Company (Wyomissing, PA)
- …This position is intended to develop skills for investigating, evaluating, negotiating and resolving First Party Medical claims on losses of lesser ... level position that requires satisfactory completion of a formal training program to advance to Claim Representative - Auto First Party Medical position.… more
- Travelers Insurance Company (Pittsburgh, PA)
- …position is responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and ... include interpreting and applying laws and statutes for multiple state jurisdictions. Claim types include moderate complexity Bodily Injury claims . Provides… more
- Select Medical (Camp Hill, PA)
- …Equivalent + One year of experience (2+ years for remote candidates) within a medical billing, medical collecting or claims processing role. **Preferred:** + ... discretion and secure information management. **Additional Data** **Your benefits as a Claims Resolution Specialist:** Select Medical strives to provide our… more
- Select Medical (Canonsburg, PA)
- …(Managed Care Medicaid Claims )** **- Join Our Team at Select Medical !** **Starting Pay:** $17..00 per Hour (DOE) **Work Schedule:** Monday - Friday, Daylight ... and want to grow your career in healthcare? Select Medical is looking for motivated individuals to join our...part of our team, you'll help resolve outstanding insurance claims , ensuring our patients are billed accurately and without… more
- Sedgwick (Harrisburg, PA)
- …assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims . + Knowledge of total ... + Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of ... Utilizes provider documentation and queries, coding software tools and Insurance carrier medical and reimbursement policies during the claim review process. JOB… more
- St. Luke's University Health Network (Allentown, PA)
- …of the activities related to third party claim form formats, claim "scrubbing," claim submission and claims editing to ensure optimal reimbursement ... + Provides guidance and/or assists AR specialists in third party claims submission process. + Assists in...trained. + Identifies system or procedural problems creating third party claim rejections. Formulates and implements plans… more
- St. Luke's University Health Network (Allentown, PA)
- …Receivable Specialist II is focused on the accurate and timely submission of claims to third party payers, intermediaries, and guarantors in accordance with ... DUTIES AND RESPONSIBILITIES: + Process all UB04 and HCFA-1500 claims through the related billing system, working the related...and writing skills. TRAINING AND EXPERIENCE: Experience with third party billing in a hospital similar medical … more
- Select Medical (Camp Hill, PA)
- …Account Representative position may be a phenomenal career for you within Select Medical ! Our dynamic team has the responsibility of resolving outstanding insurance ... claims so that our patients are not impacted. We...paid training, and advancement opportunities. Our team offers flexible, first shift, Monday through Friday schedules. This would include… more
- Highmark Health (Harrisburg, PA)
- …requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and ... ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's… more
- CVS Health (Monroeville, PA)
- …Training: First 2-3 weeks of employment. **What you will do** + Third party insurance claim billing associated with the dispensing medication and using the ... area, has an opportunity available for a full time Pharmacy Claims Biller/Adjustment Specialist. As a Biller/Adjustment Specialist, you will ensure timely… more
- UPMC (Pittsburgh, PA)
- …service and/or call center experience + Advanced knowledge of health insurance, third- party pay or billing requirements, and medical terminology preferred + ... Center Specialist will support the Contact Center activities by serving as the first line of contact for the patient. The Contact Center Specialist advocates for… more
- UPMC (Washington, PA)
- …and medical terminology is preferred. + Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment ... corrective action steps to eliminate future occurrences of denials. Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks outcomes regarding appeal ... review. Provides billing with information needed to obtain payment of claims . Remote within local geography after orientation. JOB DUTIES AND RESPONSIBILITIES:… more
- Walmart (State College, PA)
- …returned, liquidated items) and merchandise deliveries (for example, suppliers, third- party deliveries). Providesdirection for claims or receiving issues. ... Manages facility-level training and execution of asset protection, safety, and claims and receiving procedures by reviewing the application of policies,procedures,… more
- St. Luke's University Health Network (Allentown, PA)
- …mitigate claim denials. Maximize opportunities to enhance front end, coding-related claim edits to facilitate first pass resolution. 9. Utilize coding ... production standard expectations as set by the department. 6. Resolve medical record documentation deficiencies through healthcare provider query, and provide… more
- CL Cressler, Inc. (Pittsburgh, PA)
- …patient profiles + Provide customer service to callers regarding orders + Assists with claim billing and adjudication to third party payers At Medicine Shoppe ... format through the pharmacy filling system and providing timely and accurate claim adjudication. Typical responsibilities associated with the position are: + Read… more
- Walmart (Woodland, PA)
- …and monitors access violations. Engages legal counsel in response to litigation claims . Tests and evaluates various types of exterior and interior security devices ... processes. Monitors investigations to ensure all details are communicated to claims providers and kept confidential. Partnership & Collaboration Possesses knowledge… more
- Performance Contracting, Inc. (Exton, PA)
- …of a signed fee agreement AND proper resume submission, PCG does not recognize any claim on a candidate by a third party , will consider unsolicited resumes the ... employees are our greatest asset. We put our people first and are proud to provide a comprehensive benefits...(ESOP) + 401(k) retirement savings plan with match + Medical , prescription drug, dental and vision insurance plans with… more
- St. Luke's University Health Network (Allentown, PA)
- …a cc ounts in their areaas upon reque st. + Stays abreast of third- party medical policies and authorization requirement changes. + Maintains relationships and ... to e nsure pr op erre imburs e ment. + Responsible for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure… more