- Providence (Anaheim, CA)
- **Description** Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Monitor check run process for ... accuracy. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative… more
- MetLife (Tampa, FL)
- …to make a meaningful impact in the lives of our customers and our communities. The Lead LTD Claims Specialist manages a caseload of long term disability ... plan provisions and within prescribed time service standards. In this role, the Lead LTD Claims Specialist will be a technical expert and emerging leader who… more
- AON (Garden City, NY)
- Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your ... with customers through verbal and written communication. Skills that lead to success: + Claims adjudication experience....and policies. #li-am4 2544710 Aon is looking for a Claims Specialist II Do you have experience… more
- Entergy (Reserve, LA)
- Customer Service Specialist - Claims **Date:** Jun 25, 2024 **Location:** Reserve, Louisiana, United States **Company:** Entergy **Work Place Flexibility:** ... This position may be filled as a Customer Service Specialist I, II or Senior** **based on the qualifications...external stakeholders in order to thoroughly and fairly resolve claims . **JOB DUTIES/RESPONSIBILITIES** + Handles claims in… more
- Subaru of America (Camden, NJ)
- SUMMARY Provides direct, day-to-day supervision of a team of Retailer Claims Specialists, including prioritizing workload, performance review and coaching, and ... checks through phone observations and claim reviews. Works together with Retailer Claims management on department operations and solutions. Serves as liaison to… more
- Trinity Health (Farmington Hills, MI)
- …draws conclusions, and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to Payment Resolution Specialists ... way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Property Claims Manager (State Risk Adjuster 6) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4534112) Apply Property Claims Manager ... information about this posting, please contact: Erica R. Gay HR Specialist Division of Administration/Office of Human Resources email: ###@la.gov Minimum… more
- Beth Israel Lahey Health (Danvers, MA)
- …not just taking a job, you're making a difference in people's lives.** The Billing Specialist role specializes in high dollar claims , aged claims and denied ... claims to ensure successful initial submission. The Billing Specialist will be responsible for charge and claim review...Home Health Billing Teams when identifying trends that can lead to inappropriate billing to the customer. 8. Working… more
- Veterans Benefits Administration (Philadelphia, PA)
- Summary Incumbent serves as a Lead Insurance Specialist for the Accounts Services Section. The Division is responsible for the oversight, and exception reporting ... documentation, into the workflow system and the Veterans Insurance Claims Tracking & Response System (VICTARS). The Incumbent will...through Friday, 6:00am - 6:00pm, flexible schedules available Title/PD#: Lead Insurance Specialist GS - 11; PD… more
- CareOregon (Portland, OR)
- Job Title Provider Relations Specialist Lead - Behavorial Health Department 116-Provider Relations Exemption Status Exempt Requisition # 24293 Direct Reports n/a ... Pay & Benefits Estimated hiring range $71,340 - $87,200, 7% lead pay, 5% bonus target, full benefits www.careoregon.org/about-us/careers/benefits Posting Notes This… more
- Modernizing Medicine (Boca Raton, FL)
- …with team members across the US. ModMed (https://www.modmed.com/company/) is hiring a driven Lead Patient Services Specialist who will play a pivotal role in ... for inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections + Review training… more
- HCA Healthcare (Miramar, FL)
- …Do you want to join an organization that invests in you as a Lead Collections Specialist -CBO? At Surgery Ventures powered by HCA Healthcare, you ... make a difference. We are looking for a dedicated Lead Collections Specialist - CBO like you to...work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims… more
- Sedgwick (Chicago, IL)
- …+ Makes independent claim determinations, based on the information received, to approve complex claims or make a recommendation to team lead to deny claims ... Most Loved Workplace(R) Forbes Best-in-State Employer Advocacy Coordination Team Specialist **PRIMARY PURPOSE** **:** Actively researches, resolves, and administers… more
- Ventura County (Ventura, CA)
- …such as Cerner, HURON, and/or Claim Source to follow up on accounts. Medical Billing Specialist IV is the lead level class and serves as technical advisors to ... affect reimbursement for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties… more
- UnCruise Adventures (Seattle, WA)
- …our team, you become an important part of our uniqueness. Job Summary The Lead Adventure Specialist directly oversees the Adventure Specialist team, ... skills as well as advanced sales training and reservations management abilities. The Lead Adventure Specialist assumes responsibility for the active phone, live… more
- Trinity Health (Farmington Hills, MI)
- …resolves payment delays and/or variances resulting from rejected and/or denied claims and/or overpayments and underpayments with direction from the Supervisor ... potential liabilities are paid in a timely and accurate fashion. Resolves claims , conducts formal account reviews, identifies lost charge recovery, analyzes and… more
- Trinity Health (Farmington Hills, MI)
- …resolves payment delays and/or variances resulting from rejected and/or denied claims and/or overpayments and underpayments. Processes payments as appropriate in ... are paid in a timely and accurate fashion. Resolves claims , conducts formal account reviews, identifies lost charge recovery,...and the appeals process. Assists in training Payment Resolution Specialist I colleagues upon hire and as new systems… more
- Ultimate Care Inc (Brooklyn, NY)
- Ultimate Care NY, a leading provider of home health care services, is seeking HR Specialist to join our team! The HR Specialist , will play a key role in ... functions and providing assistance to employees. You'll oversee the entire claims process, coordinating with insurance providers and managing medical documentation… more
- LifeSteps (Los Angeles, CA)
- Lead Care Manager Specialist Job Details...needed. + Compile records and prepare reports. + Submit claims to Managed Care Plans (MCP's) for all member ... Identity Theft Program + Pet Insurance + Paid Time Off The Lead Care Manager Specialist position assists and aids members with enhanced coordination of care.… more
- Beth Israel Lahey Health (Burlington, MA)
- …not just taking a job, you're making a difference in people's lives.** The Billing Specialist role specializes in high dollar claims , aged claims and denied ... claims to ensure successful initial submission. The Billing Specialist will be responsible for charge and claim review...Home Health Billing Teams when identifying trends that can lead to inappropriate billing to the customer. 8. Working… more