- Penn Medicine (Philadelphia, PA)
- …our future each day. Are you living your life's work? **Job Title:** Accounts Resolution Specialist II **Department:** OTO Admin **Location:** Hospital of ... office hours per department needs **Summary:** + The Accounts Resolution Specialist II reports to...claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution… more
- Guthrie (Sayre, PA)
- …and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, ... Position Summary: Responsible for non‐complex electronic and paper claim submissions to insurance payers. Coordinates required information...2. Works closely with a Denial Resolution Specialist or Billing Specialist II … more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist . This is a full-time position and offers a hybrid schedule after ... plan to manage the claim to final resolution . The Complex Claim Specialist ...policyholder's reporting practices + Prepare, attend, and participate in Claim Reviews as needed with the Claims … more
- Zurich NA (New York, NY)
- Litigated Claims Specialist II , General Liability 114800 Unlock Your Potential with Zurich North America Claims : Become a Litigated Claims ... **About the Role:** Zurich is seeking a dedicated Litigated Claims Specialist to join our team. In...customer and business partner interactions + Proficiency in presenting claim resolution information to stakeholders Join us… more
- First Student (OH)
- …To provide overall managerial and supervisory responsibilities of the Company's liability claim portfolio, particularly the higher exposure claims . This is done ... brands include Transco, Total Transportation, Maggies Paratransit, and GVC II . Our employees are at the forefront of safety...oversight of the liability and damage investigation of the claims ; oversight of third party administrator's claim … more
- Health First (Rockledge, FL)
- …Support* **Organization:** **HRE dba HF Medical Equipment* **Title:** *DME Claims Specialist - Medical Equipment Administration* **Location:** *Florida ... and issuance of refunds, identification of payment variance invoices, follow up and resolution of denied claims . *Primary Accountabilities * 1. Process medical… more
- SCI Shared Resources, LLC (Whittier, CA)
- …pre-planning, explore alternatives, and troubleshoot situations. Elevates problems up to the Account Claims Specialist II when unable to resolve. Process ... objectives. Works under the close direction of the Senior Specialist II . **Essential Job Functions:** Must be... claims and assist with third party insurance claims timely. + Submit total casket protection claim… more
- Methodist Health System (Dallas, TX)
- …resolving no response claims , denied claims , and correspondence. As an AR II Specialist , you will play a crucial role in optimizing revenue flow by ... **Your Job:** We are seeking an experienced Accounts Receivable II (AR II ) Specialist specializing...claims promptly and accurately. - Investigate and address claim denials promptly. Utilize knowledge of payor policies, medical… more
- Zurich NA (Omaha, NE)
- … Claims Specialist , Auto 116890 Zurich is currently seeking an Auto Litigation Claims Specialist II . At Zurich North America Claims , we understand ... CA. Job Responsibilities: Under moderate direction, the Auto Litigation Claims Specialist II handles single...develop and execute a negotiation strategy and plan for resolution + Skill in identifying subtleties in customer/client and/or… more
- CareOregon (Portland, OR)
- …Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Benefit Specialist II Exemption Status Non-Exempt Department Pharmacy Manager Title ... under the major medical benefit. + Follow policies and procedures to determine a resolution to pharmacy claims adjudication issues or triage to other CareOregon… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- AON (Fort Wayne, IN)
- Underwriting Specialist II K&K Insurance is a leading provider of specialty coverage in the exciting areas of sports, leisure, recreation, motorsports and ... choose K&K for our unique insurance products and expert claims resolution . As part of an industry-leading...What the day will look like As an Underwriting Specialist II , you will report directly to… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve medically necessary… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to member's… more
- University of Utah Health (Salt Lake City, UT)
- …and overall patient outcomes. **Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + Performs contract compliance on ... This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary… more
- Montana State University (Bozeman, MT)
- …Classification Title Computer Supp Spec II Working Title Computer Support Specialist II Brief Position Overview As a full-time Service Desk Analyst ... and service request management. This includes first line technical support and problem resolution for students, faculty, and staff in the use of desktop and laptop… more
- Duke Energy (Wilmington, NC)
- …experience, the level to which a candidate is aligned is outlined below. Work Management Specialist II + High School/GED degree + 2 years related work experience ... They will provide guidance to teammates on day-to-day problem resolution and invoice processing. The senior is expected to...at increasing levels of complexity of the Work Management Specialist I or II level, with little… more
- Martin's Point Health Care (Portland, ME)
- …and external partners to ensure a comprehensive appeals management process. Job Description Specialist II Key Outcomes: + Serves as daily resource for staff ... GA audits and accreditation Overall Key Outcomes: + For Medicare Focused Specialist : + Researches, processes and resolves Part C reconsiderations with 100%… more
- The Mount Sinai Health System (New York, NY)
- …and problem resolution to ensure accurate and timely payment of claims and collection. Maintains open dialogue with the Department Administrator and/or Revenue ... coding, Accounts Receivable, Charge Entry, Edits and Payment Posting. Facilitates claims processing for services rendered by physicians. Assists with responses to… more