- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 ... guidelines, claims procedures, contract provisions, and CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical Coding … more
- Sedgwick (Sun Prairie, WI)
- … that meet excess reporting criteria; ensures claim files are properly documented and claims coding is correct. + Approves and makes timely claim payments ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner - Recovery **PRIMARY PURPOSE** :...direction to both internal and external stakeholders to maximize recovery efforts in alignment with client, financial … more
- Commonwealth Care Alliance (Boston, MA)
- …in both medical and administrative cost savings. + Manage the day-to-day financial recovery vendor relationships, validating that identified overpayments are ... the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery ...and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for … more
- Houston Methodist (Houston, TX)
- …common procedure coding system (HCPCS), denial reasons, and appeals. Monitors recovery of payments and trends to identify corrective measures needed to prevent ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for...working assigned specialties and combines clinical knowledge to reduce financial risk and exposure caused by front end claim… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …appropriate parties; recommending corrective course of action\. + Reviewing the claims materials and medical record information submitted and assessing accuracy of ... provider submitted claims \. + Planning and conducting investigations for certain ..._Experience_ + 2 years \- Professional/ancillary or facility inpatient/outpatient coding and/or auditing experience in an applicable setting\. … more
- Sedgwick (Columbus, OH)
- …maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to ... meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your… more
- Crawford & Company (VA)
- …+ Evaluates medical claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and ... In Everything We Touch Position Summary Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims . Documents… more
- Sedgwick (Columbus, OH)
- …maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to ... meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your… more
- Burrell Behavioral Health (Springfield, MO)
- Job Description: Job Title: Client Financial Services Representative - Accounts ReceivableCompany: Burrell Behavioral Health Location: Remote - Work from Home ... Full Time Experience Required: Insurance billing/collection practices, CPT and ICD-10 coding , EFTs, EOBs and basic understanding of medical and insurance terminology… more
- Burrell Behavioral Health (Springfield, MO)
- …Job Title: Recoupment Representative Location: Springfield, Missouri Department: Client Financial Services Employment Type: Full-Time Shift: Mon-Fri 8am-5pm Job ... professional looking to make a positive impact in the financial operations of our healthcare organization? Do you want...the electronic health system. + Monitor and initiate voided claims , following through to recoupment. + Document workflows. +… more
- Veterans Affairs, Veterans Health Administration (IN)
- Summary The VISN 19 Consolidated Coding Unit (CCU) Supervisor is a supervisory position located within the Business Office Support Services (BOSS), Health ... and assigns codes from the current version of several coding systems to include current versions of the International...of the facility database as well as all cost recovery programs. Performs a comprehensive review of the patient… more
- AIG (Atlanta, GA)
- …with appropriate contacts, post Benefit on resolution. + Prepares for and attends claims financial review sessions as requested. + Oversees Aggregate Limit ... position will work with various claim teams to review coding of claims to ensure they meet...Request. + Promotes/fosters a strong and improving relationship between claims and recovery personnel and all clients.… more
- Keystone Lab (Asheville, NC)
- …+ Check eligibility and perform benefit verification, enter charges & transmit clean claims per coding , carrier, and contract guidelines. + Assist in daily ... in the management of patient balances, including the negotiation and recovery of outstanding balance. Essential Functions Responsibilities include but are not… more
- Providence (OR)
- …experts to identify, investigate and correct fraudulent and/or abusive billing and coding practices, which may advance in complexity with experience + Leverage ... related auditing and monitoring activities at the Health Plan + Coordinate recovery of overpayments related to fraudulent and/or abusive billing and coding… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …risk; - Value based contracts - Access center/ambulatory scheduling, switchboard - Claims submission; customer service; financial assistance, self-pay - Cash ... and other agencies, as well as a comprehensive understanding of coding /charging practices, payer contracting, billing requirements, claims processing, cost… more
- Elevance Health (Dearborn, MI)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you ... will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and procedures. +… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …their appropriate Work Participation Rates. You will monitor data entry and coding , FIA expiration dates, and 6-month FIA reviews. Ensure participants are engaged ... out. Authorize transportation and childcare allowances and initiate overpayment recovery when appropriate. Help answer questions from Promise Jobs participants… more
- Stanford Health Care (Palo Alto, CA)
- … financial management that includes revenue cycle, DRG reimbursement, coding process for inpatient and outpatient services, Medicaid, Medicare, commercial ... status and continued stay review, retrospective review of care, medical claims review, addressing denials/appeals and grievances effectively and timely, and… more
- US Bank (St. Louis, MO)
- …best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We ... lead a Bankruptcy Servicing team who may be responsible for inbound calls, coding of new bankruptcy notifications, statusing, updating, filing proof of claims ,… more
- Burrell Behavioral Health (Springfield, MO)
- …visits + Employee Assistance Program - 24/7 counseling services, legal assistance, & financial consultation for you and your household at no cost + Paid Time ... investigations into suspect billing for Federal health care program overpayments. + Analyze claims data for potential fraud waste, and abuse patterns. + Prepare and… more