- 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 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 (Louisville, KY)
- …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** **Job Summary** Responsible for reviewing Medicaid , Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, ... tools such as DSHS and Medicare billing guidelines, Molina claims ' processing policies and procedures, and other...of 1 year experience in healthcare insurance environment with Medicaid , or Managed Care + Strong verbal and written… more
- Trinity Health (Farmington Hills, MI)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting or ... of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates… more
- NTT America, Inc. (Plano, TX)
- "NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible ... MS-Excel. Preferred Skills & Experiences: * Amisys or Xcelys * Medicaid and Medicare Claims processing experience * Ability to communicate (oral/written)… 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 (Tallahassee, FL)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- ManpowerGroup (Marquette, MI)
- …Marquette, MI Pay: $16.32 per Hour What's the Job? - Accurately process Medicaid claims in compliance with policies and regulatory guidelines. - Maintain ... - Meet or exceed production and quality goals for claims processing . - Assist with training new...unpaid lunch. - Required: High school diploma or GED ( Associate degree preferred). - Required: 1 year experience in… more
- Marshfield Clinic (Marshfield, WI)
- …come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP- Claims ... shifts (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround… more
- McLaren Health Care (Flint, MI)
- …specifications for all information systems, including benefiting and pricing requirements for claims processing . Develops and maintains reporting as needed by ... We are looking for a Claims Coding Specialist, to join us in leading...the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and… 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
- IQVIA (Wayne, PA)
- …issues. **Essential Functions and Responsibilities:** + Responsible for **pharmacy prescription claims processing ** , translating strategy into proactive plans ... Job Description Summary: ** Associate Director Finance Operations** Directs financial planning and...payees. + Identify and manage **payment data related to claims , rebill, and manage overrides.** + Audit readiness and… 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
- Humana (Tallahassee, FL)
- …and other resources to provide insight and ensure data integrity for Medicare/ Medicaid claims errors. **Key Role Functions** + Develop business processes ... data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and… more