- MultiPlan (Atlanta, GA)
- …Utilize analytics and data mining and coordination of benefits techniques to client paid claims data.3. Evaluate medical claims for coding and pricing errors ... using accurate HCPCS, ICD-10, and CPT codes. 4. Lookup and review medical claims in payer system to determine methods of payment and validate savings identified.… more
- Staffing Now (Boston, MA)
- Our Boston, MA healthcare client is seeking a temporary Medical Claims Processor to work M-F 8:30am-5:00pm in their Downtown Crossing office. Duties: Open and ... sort mail, check medical claims ...sort mail, check medical claims for accuracy and manually enter claims ...claims into an Excel spreadsheet. 1-2 years of medical claims experience. Must be proficient in… more
- MultiPlan (Atlanta, GA)
- …healthcare providers to discuss negotiations for a specific dollar range of eligible claims /bills prior to payment, in order to achieve maximum discounts and savings ... JOB ROLES AND RESPONSIBILITIES: 1. Manage a high volume of healthcare claims thoroughly to maximize savings opportunities on each claim within the established… more
- US Tech Solutions, Inc. (Hamilton Township, NJ)
- …Office Outlook, Word and Excel* General knowledge of PC* Good working knowledge of medical claims systems* Knowledge of CPT/HCPCS and ICD9 coding procedures and ... Job Title: Claims Resolution Representative Location: Onsite at Hamilton Township,...of extension) Job Description: . Looking for candidates as Claims Resolution Representative who can resolve customer issues in… more
- Rose International (Long Beach, CA)
- …properly documented and claims coding is correct * May process complex lifetime medical and/or defined period medical claims which include state and ... Posted: 05/09/2024 Hiring Organization: Rose International Position Number: 463794 Job Title: Claims Examiner Job Location: Long Beach, CA, USA, 90806 Work Model:… more
- Staffing Now (Tampa, FL)
- …of claim types to include facility, professional, inpatient and outpatient services *Follow claims adjudication rules to assure that all claims are adjudicated ... * Authorize claim payments within established limits; otherwise forward to Claims Manager * Potentially process refunds appeals, disputes and adjustments (when… more
- AppleOne (Pittsburgh, PA)
- …to individuals navigating workers' compensation claims ? We're looking for a dedicated medical claims coordinator to join our team and play a vital role ... to a supportive team environment, we want to hear from you! Apply now to become our newest Claims Coordinator and embark on a fulfilling career journey with us. more
- Insmed Incorporated (Bridgewater, NJ)
- …in HEOR research including burden of illness studies, patient evidence studies, medical claims and electronic health records database analyses, economic models, ... Director collaborates with key stakeholders across the company including Training/ Medical Excellence, Field-based/ Medical Outcomes Liaisons (MOLs)/ Medical… more
- Insmed Incorporated (Bridgewater, NJ)
- …implements HEOR research including burden of illness studies, patient evidence studies, medical claims and electronic health records database analyses, economic ... collaborates with stakeholders across the company including market access, marketing, medical affairs, and clinical development to support Insmed's business needs.… more
- Insmed Incorporated (Bridgewater, NJ)
- …subject matter expert including burden of illness studies, patient evidence studies, medical claims and electronic health records database analyses, economic ... team members and others across the company including market access, marketing, medical affairs, and clinical development to support Insmed's business needs. This is… more
- APN Consulting, Inc (TX)
- …an FTE with a positive work record.Summary:This position works under the supervision of the Medical Claims Review Nurse and is cross-trained to work in a variety ... Job Title: Healthcare - Medical Assistant VRemoteDuration: 6 months Job Description: What...of areas and functions, including appeals, claims analytics, DRG Validation claims repricing, and… more
- Spectraforce Technologies Inc (Columbia, SC)
- … and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non- medical appeals. Determines whether to return, deny or ... reprocessing actions according to department guidelines. 40% Examines and processes claims and/or non- medical appeals according to business/contract regulations,… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …either the facts of the case or the claim type; determines compensability of claims , manages the medical treatment program, and assists in the return-to-work ... Role:Job SummaryPrimarily responsible for the investigation and management of workers' compensation claims . Conducts a 1 to 3-point contact on the managed claims… more
- LHH Recruitment Solutions (Phoenix, AZ)
- …Medical Biller, you will play a crucial role in processing and submitting medical claims to insurance companies or government payers for reimbursement. You ... LHH Recruitment Solutions is currently seeking a Medical Biller for a growing organization. As a...for the services they render. Qualifications 3+ years of Medical Billing experience High School Diploma or equivalent Knowledge… more
- Spectraforce Technologies (Columbia, SC)
- …indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Responsibilities: 80% May provide any ... of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment… more
- Dexian - DISYS (Baltimore, MD)
- …may include performance of audits of financial business records, provider and subscriber medical data, claims , systems reports, medical records, analysis of ... for offsite audits/investigations and interviews when requested. Research provider/subscriber claims activity, operations manuals, data systems, medical … more
- US Tech Solutions, Inc. (Columbia, SC)
- …using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. May provide any of the following ... in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination.… more
- nTech Solutions, Inc. (Baltimore, MD)
- …may include performance of audits of financial business records, provider and subscriber medical data, claims , systems' reports, medical records, analysis of ... for offsite audits/investigations and interviews when requested. Research provider/subscriber claims activity, operations manuals, data systems, medical … more
- Option Care Health (Dublin, OH)
- …financial assistance program).Supports the ongoing activities needed to ensure clean claims on hold and denial management (follow-up on paperwork where ... and operation functions. Travel RequirementsN/A Preferred Qualification & InterestsPrevious healthcare/ medical billing experience preferred. Due to some state pay… more
- AppleOne (Jacksonville, FL)
- …to ensure timely and accurate billing and reimbursement.Key Responsibilities:Process and submit medical claims to insurance companies electronically or by paper ... We are seeking a detail-oriented and experienced Medical Billing Specialist to join our teamThe ideal...requirements (ICD-10, CPT, HCPCS).Follow up on unpaid or denied claims and resubmit as necessary.Post payments and adjustments to… more
