- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve ... the resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and… more
- Humana (Madison, WI)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 3 manages claims operations that involve ... for and against the organization. The Claims Research & Resolution Representative 3 performs advanced administrative/operational/customer support duties… more
- NTT DATA North America (Plano, TX)
- …as part of an overall sourcing strategy. NTT DATA currently seeks a Remote **Medical Claims Representative ** to join our team in **for a remote position** . This ... complete compliance training of NTT Data/Client -Work independently to research , review and act on the claims ...above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as… more
- Intermountain Health (Raleigh, NC)
- …payments to patient accounts, using both electronic and manual posting systems + Research , validate and make adjustments to payment postings. Follow up in accordance ... procedures and policies with an overall goal of account resolution + Post correspondence, zero payments, denials and any...additional items received from insurance to patient accounts + Research and follow-up on missing information, such as EOB… more
- University of Rochester (Albany, NY)
- …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative III is responsible for ... routine action to resolve unpaid claims . The Claims Resolution Representative III reports...(EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Research claims ,… more
- Travelers Insurance Company (Irvine, CA)
- …or their legal representatives. + Recognizes and implements alternate means of resolution . + Manages litigated claims . Develops litigation plan with staff ... and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Travelers Insurance Company (San Diego, CA)
- …or their legal representatives. + Recognizes and implements alternate means of resolution . + Manages litigated claims . Develops litigation plan with staff ... and resolving assigned Specialty Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- UNC Health Care (Chapel Hill, NC)
- …a variety of complex duties, including but not limited to, working outstanding insurance claims follow up for no response from payors, and/or claim denials. + Works ... physician claims ("professional billing"). + Maintains A/R at acceptable aging...through charge corrections, payment corrections, write-offs, other methods. + Research medical records to gather information and substantiate medical… more
- BJC HealthCare (St. Louis, MO)
- …and billing resolution ; resolves complex accounts and ensures their full resolution . + Contacts insurance companies regarding complex claims , updates account ... the Role** BJC HealthCare is seeking a Patient Accounts Representative to assist with physican billing follow up. Duties...billing follow up. Duties for this role include working claims , contacting payors, and filing appeals in hopes to… more
- University of Virginia (Charlottesville, VA)
- …processed and followed up to meet the CBO Revenue Cycle performance metrics & representative Facility specific goals. They will also research and answer all ... The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing...from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and… more
- AmeriHealth Caritas (Philadelphia, PA)
- …is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the full life cycle of assigned member and/or ... case intake, investigation, and documentation to ensure accurate and timely resolution consistent with federal state, and accreditation standards. The Specialist… more
- CHS (Clearwater, FL)
- …call resolution and satisfaction. The Member and Provider Service Representative (MPSR) is critical to PAS' success, effectively and efficiently handling calls ... **Overview** ** ** **Medical Insurance Call Center Representative | Member and Provider Services Representative...Supervisor. + For any calls or correspondence where additional research is necessary, clearly explaining to the caller the… more
- Sedgwick (Memphis, TN)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Billing Representative **PRIMARY PURPOSE** : To analyze and reconcile assigned client claim ... and deliver invoice reporting packages to clients; and to identify, research , and resolve problems/issues for internal and external customers. **ESSENTIAL FUNCTIONS… more
- Mass Markets (Dallas, TX)
- POSITION OVERVIEW TECHNICAL SUPPORT REPRESENTATIVE (FULL-TIME) As a technical support representative , you will handle blended inbound phone interactions with ... contacts in a courteous, timely, and professional manner + Ensure first call resolution through problems solving and effective call handling + Research systems… more
- Martin's Point Health Care (Portland, ME)
- …or resolution . This should be completed within the timeframes outlined in Representative Expectations document. + Collaborates with PI Research team and or ... + Ability to work efficiently and independently. + Analytical skills in research and problem resolution . + Strong computer skills (keyboard proficient,… more
- Mass Markets (Wichita, KS)
- POSITION OVERVIEW CALL CENTER REPRESENTATIVE (FULL-TIME) We are looking for full-time call center representatives to support inbound and outbound customer service ... wide variety of clients. In this role, you will identify customers' needs, research every issue, provide solutions, and upsell customers on new products and… more
- Mass Markets (Dallas, TX)
- POSITION OVERVIEW CALL CENTER REPRESENTATIVE (FULL-TIME) We are looking for full-time call center representatives to support inbound and outbound customer service ... wide variety of clients. In this role, you will identify customers' needs, research every issue, provide solutions, and upsell customers on new products and… more
- TEKsystems (Troy, MI)
- …Job Responsibilities: + Manage 40-50 inbound calls daily related to existing homeowner claims + Navigate multiple systems to research and provide accurate claim ... composure + Document interactions and updates thoroughly in the claims system + Demonstrate strong problem-solving and resolution... claims system + Demonstrate strong problem-solving and resolution skills + Make outbound calls as needed to… more
- Molina Healthcare (GA)
- …member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution , and the development/maintenance of Member/Provider ... of the call/ issue and following it through to resolution , on behalf of the customer, in real time...wide variety of inquiries and assistance involving their benefits, claims , premiums, and other areas including very complex issues.… more
- Mass Markets (Dallas, TX)
- …Listen to customers, understand their needs, and resolve customer issues + Research systems to find missing information as applicable; coordinate with other ... account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,...customer issues to the appropriate staff and managerial for resolution as needed. + Ensure first call resolution… more