- Penn Medicine (Philadelphia, PA)
- …future each day. Are you living your life's work? **Job Title:** Accounts Resolution Specialist II **Department:** OTO Admin **Entity:** CPUP **Location:** ... St **Hours:** Full time regular **Summary:** + The Accounts Resolution Specialist II reports to...claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution… more
- Trinity Health (Farmington Hills, MI)
- …as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues upon hire and as new systems and processes ... and variances, make corrections, and take appropriate corrective action to ensure timely claim resolution . + Proactively follows up on payment delays and… more
- Acuity Brands (Conyers, GA)
- …entry, simple to medium order management, intake of all customer inquiries and resolution of any small task , regardless of domain. Candidate should continually seek ... a customer does not have to repeat information * Diagnose issue/need; Submit RFA/ claim /CFA form on behalf of the customer per company policy **Company Initiatives:**… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist . This is a full-time position and offers a hybrid schedule after ... plan to manage the claim to final resolution . The Complex Claim Specialist ...policyholder's reporting practices + Prepare, attend, and participate in Claim Reviews as needed with the Claims … more
- City of Columbus (Columbus, OH)
- Workers' Compensation Claims Specialist (Employee Benefits Analyst II ) (Vacancy) Print ... (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/4505699) Apply Workers' Compensation Claims Specialist (Employee Benefits Analyst II ) (Vacancy) Salary… more
- Zurich NA (New York, NY)
- Claims Specialist II , General...+ Ability to present information necessary to propose a claim resolution to stakeholders. Compensation for roles ... should be expected. Zurich is currently looking for a ** Claims Specialist II ** to report...develop and execute a negotiation strategy and plan for resolution . + Ability to identify subtleties in customer/client and/or… more
- Zurich NA (Woodland Hills, CA)
- …Litigation Claims Specialist 113285 Zurich is currently seeking an Auto Litigation Claims Specialist II . At Zurich North America Claims , we ... Hills. Job Responsibilities: Under moderate direction, the Auto Litigation Claims Specialist II handles single...develop and execute a negotiation strategy and plan for resolution + Skill in identifying subtleties in customer/client and/or… more
- Methodist Health System (Dallas, TX)
- …resolving no response claims , denied claims , and correspondence. As an AR II Specialist , you will play a crucial role in optimizing revenue flow by ... **Your Job:** We are seeking an experienced Accounts Receivable II (AR II ) Specialist specializing...claims promptly and accurately. - Investigate and address claim denials promptly. Utilize knowledge of payor policies, medical… more
- LA Care Health Plan (Los Angeles, CA)
- Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals Department: Claims Integrity Location: Los ... that purpose. Job Summary The Coordination of Benefits (COB) Validation Specialist ensures the accurate coordination of healthcare benefits for individuals covered… more
- Guthrie (Towanda, PA)
- …spreadsheets, creates and runs reports as needed to be used in the resolution of outstanding claims (ex. trending, projects, worklists) Identifies trends and ... Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a...required and requested. Works with insurance payers on problem claims and processes. Resolves outstanding Accounts Receivable and credit… more
- CareOregon (Portland, OR)
- …Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Benefit Specialist II Exemption Status Non-Exempt Department Pharmacy Manager Title ... under the major medical benefit. + Follow policies and procedures to determine a resolution to pharmacy claims adjudication issues or triage to other CareOregon… more
- Beth Israel Lahey Health (Burlington, MA)
- …helps to resolve callers' issues, retrieving critical information that impacts the resolution of current or potential future claims . 3. Establishes relationships ... with third party payor representatives in order to resolve claims issues. 4. Reviews claim forms for...Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- City of Detroit (Detroit, MI)
- Contract and Procurement Specialist II Print (https://www.governmentjobs.com/careers/detroit/jobs/newprint/4496642) Apply Contract and Procurement ... Specialist II Salary $56,807.00 - $76,242.00 Annually Location MI, MI...compliance with the terms and conditions of contracts, including resolution of problems concerning the obligations of the parties;… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve medically necessary… more
- Navient (HI)
- …WORK MUST BE PERFORMED IN THE UNITED STATES. Xtend Healthcare is looking for an Insurance Specialist II who will be responsible for review and resolution of ... appropriate next steps to bring aged account receivables to resolution . The Insurance Specialist will be responsible...knowledge of Prism system and displays clear understanding of claim updates, request workflow, and action step entry into… more
- University of Utah Health (Salt Lake City, UT)
- …and overall patient outcomes. **Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + Performs contract compliance on ... This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training...additional service needs according to specific program guidelines. Uses claims processing and care management software to look up… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to member's… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY * The Revenue Cycle Specialist II will be responsible for the review, minor analysis, trending and follow up of Third Party Claims ... to include the identification, billing and collection of payments. The Revenue Cycle Specialist II will actively engage with other departments to ensure timely… more