- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Quality Specialist II is responsible for examining and evaluating the accuracy of transactions in accordance with ... in projects. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and compliance… more
- CenterWell (Jefferson City, MO)
- …+ Guide/instruct and support agency personnel encompassing all aspects of insurance and non- Medicare claims processing. + Prepare input data forms to update ... help us put health first** As an **Accounts Receivable Specialist ** , you will: + Ensure the coordination of...timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily.… more
- Ventura County (Ventura, CA)
- …for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical ... processing claims for timely reimbursement and compliance with Medi-Cal, Medicare , and general insurance requirements. Please include the following in your… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Medicare Supplement, and individual plans._** **Responsibilities** **Cash Recovery Specialist ** Reviews and research routine to moderately complex refunds and ... projects, etc.). . Performs other duties as assigned. **Qualifications** **Cash Recovery Specialist ** . Associate Degree in Business or Healthcare Administration… more
- State of Massachusetts (Boston, MA)
- …of liens are issued and deadlines are met. * Report out on findings as needed. * Medicare Claims Reporting and Claim Handling * * Work with A&F IT to ensure ... of the Director of Workers' Compensation, the Workers' Compensation Specialist is responsible for overseeing specialty programs that fall...this field. * Ensure receipt, review and acknowledgement of claims made by Medicare to HRD/WC. *… more
- Elderwood (Buffalo, NY)
- …The Pharmacy Billing Specialist is responsible for electronic billing of Medicare , Medicaid and Third Party Insurance claims , utilizing Frameworks LTC ... Pharmacy Billing Specialist Responsibilities: + Electronic billing of Medicare , Medicaid and Third Party Insurance claims utilizing Framework… more
- Texas A&M University System (Dallas, TX)
- Job Title Clinical Coding Specialist I Agency Texas A&M University Health Science Center Department Oral Surgery Proposed Minimum Salary $22.00 hourly Job Location ... What we want The College of Dentistry is looking for a Clinical Coding Specialist I to serve in the Comprehensive Dentistry department. We desire an individual who… more
- Trinity Health (Livonia, MI)
- …efforts for professional services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims Processing Manual, ... services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims...in a health care setting. The minimum of an associate 's degree is required, Bachelors preferred. 2. Additional coding… more
- The Arora Group (Fort Sam Houston, TX)
- …thirty minute or one-hour (non-compensable) lunch break. DUTIES OF THE MEDICAL BILLING SPECIALIST : + Monitors insurance claims and patient accounts in work ... + Manages and works assigned queues to appropriately process claims , including clearing house claims . + Research...Certified Professional Biller (CPB) or Certified Billing and Coding Specialist (CBCS) or Associate college degree in… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II (D-SNP) Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more
- Trinity Health (Columbus, OH)
- …**Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... and do the right thing. **Position Purpose:** The Operations Resolution Specialist researches, analyzes, documents, and coordinates the resolution of escalated… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and… more
- Trinity Health (Chelsea, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Fairview Health Services (Minneapolis, MN)
- …claim issues. Maintain accurate billing and collections for home infusion claims , performing collection tasks and analyzing accounts for necessary documentation. ... according to established procedures to support day-to-day operations Process home infusion claims accurately and timely. + Review accounts for all needed information… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that… more
- HCA Healthcare (Nashville, TN)
- …invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Editor Specialist with Work from Home you can be a part of an organization that ... We are looking for an enthusiastic Inpatient Coding Editor Specialist to help us reach our goals. Unlock your...with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assigns interim… more
- Trinity Health (Ann Arbor, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... school diploma or an equivalent combination of education and experience. Associate degree in Accounting or Business Administration highly desired. **Experience:** +… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Provider Contract Specialist (Remote Option within SHP Service Area) **Cost Center:** 101651230 Payor ... States of America) **Job Description:** **JOB SUMMARY** The Provider Contract Specialist works in cooperation with the Contracting Manager - Marshfield Clinic… more
- Catholic Health (Buffalo, NY)
- …and site and System revenue cycle leadership, the Pharmacy / Infusion Revenue Specialist will be responsible to participate in oversight of charge capture, charge ... of various insurance providers as well as federal research billing rules, Medicare and Medicaid as well as medications, 340B, and medication procurement processes.… more
- Centene Corporation (Olympia, WA)
- …as assigned + Complies with all policies and standards **Education/Experience:** Associate 's degree and claims processing, billing and/or coding experience ... office, customer service within a healthcare organization, and medical claims . Knowledge of health care, managed care, Medicare... claims . Knowledge of health care, managed care, Medicare or Medicaid.Pay Range: $22.79 - $38.84 per hour… more