- 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 ... to DRG-based reimbursement. Qualifications Responsibilities Perform DRG validation and quality audit on claims , providing coding expertise in the application… more
- Solugenix (Los Angeles, CA)
- …Claims is responsible for various tasks within the Financial Compliance Unit, including the audit of claims processed by medical groups and health plans ... contractual requirements. Communicate issues and findings that would affect the audit results. Perform claims audits for all medical groups and health plans… 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
- Stanley Black & Decker (Towson, MD)
- …and detail-oriented individual to join our Legal Team as a Supervising Claims Coordinator. In this position, you will provide administrative support to Product ... including quarterly reporting to Medicare's claim systemCMS. Preparing quarterly Mass Tort audit and summary for EII Board Meetings. Receiving M&S Mass Tort… 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
- Matheson Tri-Gas, Inc. (Irving, TX)
- …and international regulations. Assist with management of worker's compensation claims through communication with MATHESON employees, insurance representatives, and ... medical providers. Assist with management of auto, property, and...providers. Assist with management of auto, property, and liability claims through communication with MATHESON employees, insurance representatives, service… more
- The Christ Hospital (Cincinnati, OH)
- …team to identify and resolve issues related to the billing and collections of medical claims , as well as patient and insurance provider payment posting. May ... Responsible for the research and resolution of all unpaid claims and the preparation of appeals for rejected or...submission, billing edits, payer processing requirements, and claim / medical records audit procedures REQUIRED SKILLS AND… 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 ... wholesaler invoice reviews Quarterly PSA reviews Quarterly CE self- audit collection and review b. Assists the external, independent audit team in collection and… 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...your Birthday off Paid Parental Leave for FT employees Medical , Dental, Vision Benefits with Health Saving Account (HSA)… more
- RenaissanceRe (New York, NY)
- …our industry-leading ability to understand risk, source efficient capital and rapidly pay claims . Our global team shares a passion for solving our customers' biggest ... paying cash. The team supports and works closely with underwriters, finance, claims , and reserving, among other departments, to ensure complete and accurate… 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...in one or more of the following areas required: Medical bill auditing Experience in the acute clinical areas… more
- Walgreens (Fairmont, NC)
- …Continuous Quality Improvement Program. Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up ... with insurance companies as well as medical providers and conducts or participates in 3rd party audit . Assists and supports Store Manager and Pharmacy Manager in… more
- ICL (New York, NY)
- …and quality of treatment plans Ensure that the charts by staff are audit -ready and in compliance with all applicable agencies and funded regulations Monitor services ... for those out of compliance Ensure staff are obtaining info, such as medical , psychological, and social factors contributing to the residents' situation, and that… more
- O'Reilly Auto Parts (Indianapolis, IN)
- …core and warranty returns are picked up and credited in a timely manner. Audit customer returns for warranty abuse and makes sure all returns are tagged/labeled ... duties, ie, auto-load, returns, stock, etc., as needed. Assist with customer labor claims , making sure they are processed quickly and efficiently. All other duties… more
- Monarch Healthcare Management (St. Paul, MN)
- …billing (including Medical Assistance), and handles collections, refunds, insurance claims , and reporting. Financial and Audit Preparation: Balances accounts ... Benefits Include: UKG Wallet - get paid the next day! Free Single Medical Insurance Loan reimbursement. Scholarship Opportunities Paid Time Off - Vacation Time 401… more
- City of South Gate, CA (South Gate, CA)
- …Budget Manager on fund forecasting and grant activity. Oversee the preparation, audit , and disbursement of claims , accounts payable, payroll, and collections; ... process and ensure timely delivery of required documentation. Oversee the preparation, audit , and disbursement of claims , accounts payable, and payroll… more
- Main Line Health (Broomall, PA)
- …Payment System/Outpatient Perspective Payment System (IPPS/OPPS) reviews inpatient hospital claims for proper reimbursement and handles provider disputes in a ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters,… more
- Chubb (Boston, MA)
- …as well as following a referral process to maintain compliance and audit standards. Underwrite Builder's Risk and other Inland Marine coverages. Cross-sell ... demonstrated the ability to drive profitable new business revenue while adhering to audit and compliance requirements. The following are required : Minimum 2 years… more
- Starts Align LLC (New York, NY)
- …for subcontractor agreements and owner agreements, and overseeing the workers compensation claims and insurance claims for the company. This company is ... tailored communication based on relevance and accountability Monitor and audit internal processes, vendor and subcontractor insurance compliance, and subcontractor… more
