- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be ... responsible for developing prospective claims auditing and clinical coding and reimbursement edits and...the request based on business needs and requirements, provider resolution option based on financial ability and forecasting for… more
- Sedgwick (Columbus, OH)
- …management, executive, cyber, professional liability, error and omissions, and complex liability claims ; to provide resolution of highly complex nature and/or ... relationships. + Ensures claim files are properly documented and claims coding is correct . + Refers cases...(CPCU), Associate in Risk Management (ARM), Associate in Insurance Claims (AIC), Certified Professional in Health Care… more
- Trinity Health (Farmington Hills, MI)
- …Services (PBS) center. Serves as part of a team of coding payment resolution colleagues at a PBS location responsible for identifying and determining root causes ... This position reports directly to the Supervisor Clinical/Coding Payment Resolution . **ESSENTIAL FUNCTIONS** Knows, understands, incorporates, and demonstrates the… more
- Walmart (Orlando, FL)
- …return messages, reject codes, and insurance problem descriptions; reprocessing third-party claims using the correct procedures to resolve issues; rescanning ... practitioners throughout the country. We are hiring a full-time 2nd shift Certified Pharmacy Technicians for our Orlando, Florida location. The candidate must meet… more
- Walmart (Orlando, FL)
- …return messages, reject codes, and insurance problem descriptions; reprocessing third-party claims using the correct procedures to resolve issues; rescanning ... Position Summary What you'll do We are hiring Certified Pharmacy Technicians for our Orlando, Florida location. The candidate must meet state requirements to work as… more
- University of Rochester (Rochester, NY)
- …a payment date from the payer. + Research and calculate underpaid or overpaid claims ; determine final resolution . + Re-calculate claim based on fee schedule, APC ... add-ons + Follow up with payers on incorrectly paid claims through final resolution and adjudication, including...correct full reimbursement + Billing primary and secondary claims to insurance + Review paper claims … more
- PeaceHealth (Vancouver, WA)
- … claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization. **Details of ... accepted billing practices to ensure thorough and consistent account resolution to promote financial health. This position ensures appropriate...from patients and insurance companies as it pertains to correct and timely billing of claims , and… more
- University of Rochester (Rochester, NY)
- …such as demographics, insurance company, diagnosis, modifiers, etc. Determines correct method of resolving discrepancies by utilizing internal and external ... and location. Correctly identifies diagnosis codes and charges are appropriate for claims to be effectively released and submitted to the assigned insurance… 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
- 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
- Butterfly Effects (Deerfield Beach, FL)
- …and EOB's to resolve claim issues. + Review clearing house for denials and corrected claims submitted. + Correct and resubmit claims denied for billing ... and HIPAA regulations. Primary Responsibilities: + Verify client demographics, authorizations, correct CPT codes, and all claim details relating to claim denials… more
- Commonwealth of Pennsylvania (PA)
- …OF WORK As an Accountant 2, you will review financial statements and claims processing data submitted by managed care organizations. You will conduct financial ... box below. 10 Are you currently licensed as a Certified Public Accountant (CPA)? + Yes + No 11...reclassification, and corrections within Generally Accepted Accounting Principles to correct or close accounts. Processes revenue in all payment… more
- Central Maine Medical Center (Lewiston, ME)
- …and accuracy of Patient Financial Services processes (such as claims processing, payment variances, payment posting, accounts receivable management, financial ... is specifically responsible for any of the following: + Claims Processing + Claims Edit Management (DNFB)...Payer Analytics + Accounts Receivable Management + Payment Variance Resolution , including Patient and Payer Credits + Patient Follow… more
- Ford Motor Company (Chicago, IL)
- …or Green Belt certified + Utilize 6-Sigma methodology to drive issue resolution + Support VRT/VQR report out with manufacturing 6 Panel presentations + Support ... using the BSAQ process + Support clarification of GSAR by reviewing warranty claims , GCQIS, and additional internal indicators (First run, CAL, VOW cell, VOW SPC)… 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
- Southwire (Carrollton, GA)
- …control by using tools and technologies such as cameras and poka-yoke to inhibit, correct , or highlight when an error occurs. * Works with plant operations to lead ... * Assists in driving progress toward prompt Supplier Claim resolution , makes claim presentations to Suppliers as needed (plant...to Suppliers as needed (plant specific), and evaluates customer claims pertaining to the Plant and works toward timely… more
- State of Colorado (Colorado Springs, CO)
- …accommodation, grievances and correspondence by independently researching and evaluating claims and requests to determine appropriate offender placement and ... access. Develop and implement ADA training and education for staff through certified ADA expertise, knowledge and resources based upon federal, state and local… more
- Houston Methodist (Houston, TX)
- …for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections activities on simple ... and Account Managers to communicate and prevent denials. Provides suggestions for resolution . + Assists with knowledge sharing, payor and department cross training,… more
- The County of Los Angeles (Los Angeles, CA)
- …and reports performance issues to a higher-level technologist or supervisor for resolution ; records results of the preventive maintenance in maintenance log. + ... Sleep Technologist (RST) by the American Board of Sleep Medicine + Certified Pulmonary Function Technologist (CPFT) by the National Board for Respiratory Care… more
- The County of Los Angeles (Los Angeles, CA)
- …large size by controlling all aspects of cost and schedule, and through resolution of issues that pertain to successful project delivery; Coordinates the input and ... A valid certification by the Construction Management Association of America as a certified construction manager is required. Applicants MUST attach a copy of valid… more