- Aflac (Columbia, SC)
- Claims Compliance Coord I The Company: Aflac Columbus The Location: Columbia, SC, US, 29217 The Division: Group Voluntary Benefits Job Id: 8382 Opportunity: ... Claims Compliance Coord I Job Posting End Date: 10/17/2025 We've Got You Under Our Wing We are the duck. We develop and empower our people, cultivate… more
- AmeriHealth Caritas (Newark, DE)
- …tasks for coordination of member and/or provider appeals, the analysis of claims and appeals, and the review of medical management authorizations.; + Research ... an appeal or grievance issue + Maintains quality and compliance standards ;as dictated by the state and federal...handling of the appeal eg UM team, medical directors, claims , contact center, vendors as needed (eg PerformRX) +… more
- Catholic Health Initiatives (Hot Springs, AR)
- …all aspects of the workers' compensation program. This includes timely reporting of claims , case management support, and ensuring compliance with all applicable ... in order to advocate and provide employment status information + Report claims to TPA + Coordinate claim investigation with supervisors, injured employees, witnesses… more
- Nuvance Health (Danbury, CT)
- …all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. Responsible for the assigned areai? 1/2s ... claims submission, payment application, denial management, and account follow-up...policies and procedures related to federal, state and department compliance for the position. 10. Maintains and Model the… more
- Nuvance Health (Danbury, CT)
- …submission for designated groups of accounts by payer. Insures that all claims are compliant with State and Federal billing regulations and contractual obligations. ... Confirmation of electronic and hard-copy billing of any delinquent claims . Rebilling & follow-up of all delinquent claims...11. Adheres to all policies and procedures related to compliance with all federal & state billing & collection… more
- City of Bellingham (Bellingham, WA)
- …for Workers' Compensation and Safety. In this role, you'll manage complex injury claims , support return-to-work efforts, and ensure compliance with state and ... City of Bellingham, WA Job Type Full Time Job Number 25-Benefits Coord -AUG Department Human Resources Opening Date 08/14/2025 FLSA Exempt Bargaining Unit Eteam… more
- Nuvance Health (Danbury, CT)
- …in care coordination, discharge planning, resource stewardship, and regulatory compliance , ultimately contributing to improved patient outcomes, reduced lengths of ... This leader empowers denials/appeals specialists to meticulously investigate denied claims , prepare comprehensive appeals, and collaborate with clinical staff to… more
- OhioHealth (Columbus, OH)
- …to include but not limited to: attachment of requested dictation to claims , addition of diagnosis allowances and authorization numbers 6. Refer utilization ... the clinical, revenue and observation billers to correct or adjust any claims as directed by payer discussions. 10% ORGANIZATIONAL/OFFICE RESPONSIBILITIES 1. Sorts,… more
- Nuvance Health (Danbury, CT)
- …requests in all systems, including CERNER MILLENIUM to maintain regulatory compliance and meet operational requirements. 7.Builds exploding codes in CERNER. Ensures ... Capture preferred. .In depth knowledge of electronic data interchange and claims processing, third party payer rules, reimbursement practices and regulatory… more
- Nuvance Health (Danbury, CT)
- …timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements, guidelines, and standardized published criteria to support ... payer practices, successfully challenging payers as they prevent obstacles and deny claims and escalating any egregious payer behaviors to internal leadership for… more