- Alexander Shunnarah Trial Attorneys (Boston, MA)
- … claims -adjuster license, or any combination that shows formal training in claims , law, or healthcare documentation. Availability to be in office most ... litigation. If you're passionate about client advocacy and have experience as a Claims Adjuster or Personal Injury Case Manager/Legal Assistant, this role is perfect… more
- CERiS (Fort Worth, TX)
- …AP-DRG). At least 3-5 years of leadership or management experience in a healthcare audit or payment integrity setting. Extensive experience with ICD-9/10-CM/PCS ... and audit initiatives. This role ensures the integrity of healthcare payments by identifying and recovering improper payments, optimizing DRG assignments, and… more
- Servpro (Commerce City, CO)
- …an opportunity. We're searching for someone to join our team as a Restoration Claims Specialist. If you're ready to dive into intriguing and rewarding work and ... at our best-in-class benefits package and top- notch employee culture: Our Restoration Claims Specialist position pays $21 - $25 per hour, based on experience. We… more
- Tal Healthcare (White Plains, NY)
- …You'll play a key role in data analysis, contract modeling, audit support, and payer relations-ultimately strengthening the organization's financial health and ... Analyze reimbursement data based on contract structure and hospital-negotiated rates. Audit and reconcile plan payments to identify and report contract variances.… more
- Experis (Houston, TX)
- …Health Plan in developing an auditing and monitoring program. Develop comprehensive audit tools to objectively measure internal performance and performance of third ... Health Plan metrics, policies, regulations, and industry standards. Internal and external audit tools with measurable metrics will be created with feedback from… more
- Trinity Health (Howell, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- WMC Health (Valhalla, NY)
- …set up and maintained. Software & Data Management Maintain, test, and audit split-billing software and associated data feeds, ensuring accuracy and compliance. ... Develop and refine claims qualification logic and data feeds for contract pharmacy...Auditing & Compliance Oversight Develop and maintain a 340B audit compliance program, executing self-audits and implementing corrective action… more
- TriHealth (Cincinnati, OH)
- …which includes, but is not limited to, TPA management/oversight ( claims ), utilization management, and provider network administration. Develops and manages ... Relevant field including business, MBA, accounting/CPA, Finance/MS, economics, math or healthcare administration/MHA (Preferred) 7 - 10 years Related experience in a… more
- Washington University (St. Louis, MO)
- …leadership for all billing functions, including charge capture, coding, claims submission, accounts receivable management, and denials management. Lead continuous ... accuracy benchmarks. Facilitate regular meetings with the vendor to review audit results, resolve coding issues, and implement workflow improvements. Collaborate… more
- Vital Care Infusion Services (Pittsburgh, PA)
- …Duties/Responsibilities: Review patient files for completeness and accuracy, identify and audit claims , ensure all revenue opportunities are included, and ... 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have… more
- Walgreens (Oak Creek, WI)
- …when using the pharmacy. Enhances customer experience by increasing focus on healthcare services. Operations Responsible for assisting pharmacist in the delivery of ... allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health… more
- Walgreens (Canton, MI)
- …into the data processing system for new patient/new referrals. Participates in the review/ audit of test claims for new patient/new referral. Handles processing ... platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice… more
- ANDREWS FEDERAL CREDIT UNION (Suitland, MD)
- …include: 12 paid holidays a year including your birthday Affordable healthcare plans and Employer Paid FSA accounts Career development, training opportunities, ... processing CPI insurance adjustments and refunds, warranty cancellations and refunds, GAP claims and refunds. Supports the titles team when short staffed or as… more
- Trinity Health (Columbus, OH)
- …We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety ... of professional roles including information technology, financial analysis, audit , provider relations and more. About the job: Provider Service Specialist responds… more
- Walgreens (Cypress, TX)
- …usage of medications, awareness with drug interactions and offering preventive healthcare services such as immunizations. Responsible for ensuring the proper ... Supports efforts on enhancing customer experience by increasing focus on healthcare services (eg patient consultation, medication management, drug therapy reviews,… more
- Eaton (Beachwood, OH)
- …reporting procedures. *Responsible for overseeing the accounting for the US healthcare program ( claims and available discounts/rebates), including coordination ... forecast, balance sheet review, consolidated cash; Accounting - Legal, Asbestos, audit fees, Eaton Corp/Cooper Corp Controllership, Insurance & Risk Management,… more
- US Orthopaedic Partners (Alpharetta, GA)
- …coding and billing rules/guidelines CPT/ICD-10/HCPCS coding rules Medical terminology and healthcare compliance audit requirements CMS regulations and guidelines ... the management of coding and billing compliance matters Develop edits within claims scrubber EHR software including testing and validation Prepare and provide coding… more
- Trinity Health (Boise, ID)
- …concerns and identifies major trending patterns. Analyzes allegations of claims and complaints against the organization, and corresponding documentation. Interviews ... REQUIREMENTS: Must have active RN license. BSN preferred. Certified Professional in Healthcare Risk Management (CPHRM) preferred. 3 years of nursing experience in a… more
- Allianz (Chicago, IL)
- …procedures and workflow processes within the payroll area Archive records to satisfy audit and statutory requirements Draft standards to improve quality as well as ... From our support for flexible working, health and wellbeing (including private healthcare and generous parental leave benefits), to helping people return from career… more
- Teacher Retirement System of Texas (Austin, TX)
- …innovation to raise the bar in performance, administering and counseling pensions and healthcare benefits to ensure certainty for the future of our members. We ... for payment of goods and services, travel requests and claims for reimbursement, reconcile and post payments to the...query data and supporting documents for internal and external audit requests. *Assists with creating and providing routine and… more
