- MVP Health Care (Rochester, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detailthis is the opportunity for...New York Qualifications you'll bring: High School Diploma required. Associate degree in health, Business or related field preferred… more
- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred… more
- Commonwealth Care Alliance (Boston, MA)
- …certifications **Required Experience (must have):** + 3+ years in healthcare claims processing , provider reimbursement, or payment integrity. + Experience ... have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or...+ Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid… more
- Humana (Dayton, OH)
- …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program ... primary point of contact for the Ohio Department of Medicaid (ODM) and other agencies such as the ...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development +… more
- AmeriHealth Caritas (Charleston, SC)
- …education and experience preferred. + Required ability to focus on technical claims processing and Provider data maintenance knowledge. + Required understanding ... Configuration Department. + Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy and operational procedures to… more
- Humana (San Juan, PR)
- …assistance. See _Additional Information_ on testing. **Preferred Qualifications** + Prior claims processing experience. + Knowledge of healthcare terminology. ... first** Join Humana's dynamic Puerto Rico team as a Claims Research & Resolution Representative and make a meaningful...90 days of employment. **Language Proficiency Testing** Any Humana associate who speaks with a member in a language… more
- Dignity Health (Bakersfield, CA)
- …of complex healthcare claims . This position requires expert knowledge of claims processing , coding, and regulatory compliance. The Claims Examiner ... **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years...of CPT, ICD-10, HCPCS coding, and medical terminology. + Associate 's Degree - Associate 's Degree in healthcare… more
- Humana (San Juan, PR)
- …**Preferred Qualifications** * CIS/CIS Pro experience * Strong and proven experience with processing and adjudicating medical claims * Knowledge with CPT and ... caring community and help us put health first** The Claims Review Representative 3 makes appropriate claim decision based...opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent… more
- Trinity Health (Davenport, IA)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting, or ... and professional behavior. **MINIMUM QUALIFICATIONS** High school diploma or Associate 's degree in Accounting or Business Administration and successful completion… more
- Sanford Health (SD)
- …- $20.00 **Department Details** WFH Day 1 **Job Summary** The Associate Insurance Representative processes and monitors unpaid third party insurance, Medicare, ... Medicaid or government-assisted program accounts for proper reimbursement; primarily...but not limited to prebilled accounts. Prepares and submits claims to payers either electronically or by paper. Secures… more
- KPH Healthcare Services, Inc. (Rochester, NY)
- …Care, and private billing, claim corrections and follow-up + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems ... **Overview** **Scope of Responsibilities** : The Administration Billing Associate is responsible for identifying, researching, rectifying, and maintaining accurate… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Associate Director, Revenue Cycle Management (RCM) Optimization manages and organizes revenue strategy ... in this role assists with the strategic alignment and oversight of claims assembly and submission processes. In close collaboration with Billing, Coding, IT,… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims . + Participates in the development and implementation of TPL ... systems and policy. + Minimum 2 years professional experience with liability insurance claims processing . + Minimum 1 year professional experience with CPT,… more
- Caris Life Sciences (Irving, TX)
- …accurate, follow up on requests, and apply acquired knowledge of Medicare, Medicaid , and other Third-Party Payer requirements **Job Responsibilities** + Adheres to ... needed to complete coverage verification. + Verifies insurance eligibility to ensure claims are billed accurately and in accordance to payer guidelines. + Ensures… more
- Albany Medical Center (Albany, NY)
- …school education or equivalent + 1-2 years of experience in medical billing or medical claims processing + Working knowledge in Excel and Word + Ability to work ... credits - Complete daily review of patient accounts that are pending NYS Medicaid and/or Charity Care status - Complete monthly rejections categorized as eligibility… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... billing and processing program claims for accuracy and completeness; submit claims ...+ Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid , Medicaid Managed Care and other payers'… more
- Clark County, NV (Las Vegas, NV)
- … MEDICAID : QUESTIONS 31-36 Indicate your full-time professional experience with Medicaid billing, claims management, or reconciliation in a clinical, ... Analyst. This position will support the Fiscal, Grants, Contracts, and Medicaid program operations. These supervisory positions provide leadership and oversight in… more
- Ventura County (Ventura, CA)
- …general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance ... years + 5 or more years 02 Describe your experience with billing and processing claims for timely reimbursement and compliance with Medi-Cal, Medicare, and… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE CLERICAL ASSOCIATE CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE ... from the Social Security Administration for SN/SSI clients and SSP refunds and Medicaid Spend Down program payments. DARB is responsible for the collections, refunds… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
