- Mass General Brigham (Somerville, MA)
- …to be part of Mass General Brigham. Job Summary Perform DRG validation and quality audit on claims , providing coding expertise in the application of medical and ... Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham...DRG-based reimbursement. Qualifications Responsibilities Perform DRG validation and quality audit on claims , providing coding expertise in… more
- Solugenix (Los Angeles, CA)
- …various tasks within the Financial Compliance Unit, including the audit of claims processed by medical groups and health plans contracted with client. This ... findings that would affect the audit results. Perform claims audits for all medical groups and health plans contracted with client. Timely audit reports… more
- Marriott International (Bethesda, MD)
- …Investigations, Legal and Internal Audit , in the resolution of EPLI and Fidelity claims . Advise the Director of Specialty Claims of any high exposure ... Job Description JOB SUMMARY The Senior Manager, Specialty Claims is primarily responsible for overseeing and managing...to $154,500 annually. Marriott offers a bonus program, comprehensive health care benefits, 401(k) plan with up to 5%… more
- Aquent (Los Angeles, CA)
- …As a key member of the Financial Compliance team, you will conduct audits of claims processed by medical groups and health plans. Your meticulous attention to ... difference in the healthcare landscape. What You'll Do: Perform comprehensive audits of claims processed by medical groups and health plans, ensuring compliance… more
- Servpro (Kennewick, WA)
- …situations? Then don't miss your chance to join our Franchise as a new Restoration Claims Manager / Case Manager. In this position, you will be making a difference ... 8am - 5pm Benefits: Dental insurance- Available day 1 Health insurance- Available day 1, with 5 different plans...programs Responsibilities: Monitor job file status and job file audit status Maintain job file WIPs Monitor and ensure… more
- NYC Health Hospitals (New York, NY)
- …of projects. a. Conducts and reviews the following audits: Monthly TPA captured claims audit Monthly additional financial opportunity audit Bimonthly ... Exception - to Live the Healthiest Life Possible NYC Health + Hospitals is the largest public health...wholesaler invoice reviews Quarterly PSA reviews Quarterly CE self- audit collection and review b. Assists the external, independent… more
- TEKsystems (Phoenix, AZ)
- …of the servicer and/or client *Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits *Reviews MI claim ... and research curtailment reasons for potential rebuttal *Files Appeal or Supplemental Claims ensuring all allowable advances and interest are recovered from the MI… more
- The Travelers Indemnity Company (Glendale, CA)
- …this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim ... resolution for personal or business claims of moderate severity and complexity. Handles ...business other than property (ie auto, workers compensation, premium audit , underwriting) may be required. Provides quality claim handling… more
- Matheson Tri-Gas, Inc. (Irving, TX)
- …compliance analysis and administrativesupport for the MATHESON Corporate Safety, Health , and Environmental (SHE)Compliance and Risk Management programs; which ... and international regulations. Assist with management of worker's compensation claims through communication with MATHESON employees, insurance representatives, and… more
- Main Line Health (Broomall, PA)
- …you be our next Compliance Auditor IPPS/OPPS with Main Line Health ? Make an Impact! Compliance Auditor Inpatient Perspective Payment System/Outpatient Perspective ... Payment System (IPPS/OPPS) reviews inpatient hospital claims for proper reimbursement and handles provider disputes in a result-oriented and metrics-driven… more
- Bluebird Health (Meridian, ID)
- …operations and effective accounts receivable management. Provides oversight and approval of claims audits and processing. Conducts final billing audit and issues ... related field, Bachelor's degree preferred. At least three years' experience in health care billing and collections management preferably in home care operations.… more
- Hugo Boss (Midway, GA)
- …correctly *Respond to all CDM issue emails within 24 hours *Process all claims dealing with damaged units/cartons and or missing shipments. This incudes email ... current status of shipments *Approve import freight invoices and audit for cost savings *Manage regular entry audit...Leave for FT employees Medical, Dental, Vision Benefits with Health Saving Account (HSA) option 401(K) with company match… more
- Covenant Health (Knoxville, TN)
- …Business Office Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with ... area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the… more
- EnableComp (Franklin, TN)
- …(TM) intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by ... proprietary algorithms, iterative intelligence from 10M+ processed claims , and expert human-in-the-loop integration, EnableComp provides solutions across the revenue… more
- Providence Health & Services (Anaheim, CA)
- … health care or pharmacy billing, collections or medical claims processing. Preferred qualifications: Bachelor's Degree in Business, Healthcare Administration or ... Job Description The Pharmacy Billing Specialist is responsible to proactively audit , monitor, and analyze complex dispensing and charging information, processes and… more
- Fallon Health (Buffalo, NY)
- Overview About us: Fallon Health Weinberg is a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health ... offers a Program of All Inclusive Care for the Elderly (PACE) to serve the health needs of dual-eligible residents of the Western New York counties of Erie and… more
- Walgreens (Fairmont, NC)
- …of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health services allowed by law. Within ... Continuous Quality Improvement Program. Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up… more
- Chubb (Houston, TX)
- …profitable underwriting results for the business unit. These units include Operations, Claims , Actuarial, Loss Control and all other Chubb NA underwriting units. ... monitors and manages service standard results. Auditmanages and monitors audit process for business unit. Ensures business unit is...based on exposure and hazard analysis. Ability to analyze claims and loss trends About Us Chubb is a… more
- CERiS (Fort Worth, TX)
- …payer policy in written and verbal format Strong understanding of claims processing, ICD-10 Coding, DRG Validation, Coordination of Benefits Strong understanding ... of healthcare revenue cycle and claims reimbursement Proficient in Microsoft Office including Pivot Tables...current LPN, LVN and/or RN licensure Preferred experience with health insurance denials and/or appeals, payer audits, or vendor… more
- ICL (New York, NY)
- …in need that includes but is not limited to addiction assistance, mental health services, and housing support for all. Proudly doing so, with integrity, love, ... TBD EDU: Bachelor's Degree - in a recognized mental health discipline (social work, psychology, nursing, rehab counseling, etc.)...treatment plans Ensure that the charts by staff are audit -ready and in compliance with all applicable agencies and… more
