- Magellan Health Services (Albuquerque, NM)
- …abandonment rate, talk time). Comfortable adapting to change. General Job Information Title Claims Resolution Specialist Grade 20 Work Experience - Required ... detailed quality and professionalism. + Assists with claim dispute resolution through research and facilitating the ...all pertinent information is recorded both for ease of resolution by the Claims Department and service… more
- University of Rochester (Rochester, NY)
- …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative II is responsible for working across ... research and resolve unpaid accounts receivables, making any corrections in the professional billing system necessary to ensure balance resolution for all… more
- Travelers Insurance Company (Houston, TX)
- …and execute a strategic file management plan that achieves optimal file resolution , including as appropriate: research and recommendation of counsel; litigation ... and enthusiastic team player with extensive industry experience to join our Strategic Resolution Group Claim team as a Major Case Specialist handling complex toxic… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims **Position Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and...role will also be responsible for timely review and research , as necessary on all new and revised coding… more
- New York State Civil Service (Albany, NY)
- …New York Title Property-Casualty Insurance Claims Administrator (Risk Managment Claims Analyst) Occupational Category Other Professional Careers Salary Grade ... carriers, insurance broker contact(s), and others as necessary. * Facilitate the resolution of property and/or builders' risk insurance claims in conjunction… more
- GAF (Parsippany, NJ)
- …warranty claims , which includes but is not limited to research and investigation, assignment of work orders, preparation of various communications throughout ... protect what matters most. **Job Summary** The Residential Warranty Claims Examiner position is a critical member of our...the life-cycle of the claim, and resolution . + Apply business reasoning and critical thinking to… more
- Travelers Insurance Company (Houston, TX)
- …of junior employees. **What Will You Do?** + In the handling large exposure claims , your responsibilities may include: + Coverage Research and Analysis - ... and execute a strategic file management plan that achieves optimal file resolution , including as appropriate: research and recommendation of counsel; litigation… more
- AIG (Jeffersonville, IN)
- …Answer incoming phone calls, emails, and other correspondence concerning insurance and warranty claims in a professional manner. + Ability to interface with the ... Join us as a Claims Examiner - Bilingual to take on key...knowledge of industry and asset coverage types. + Handle research assignments and reporting as delegated by management. +… more
- FM (Waltham, MA)
- …and resolution of complex coverage issues. Interprets and executes claims policies and procedures. + Provides direction and feedback to direct reports ... business operations by drawing upon state-of-the-art loss-prevention engineering and research ; risk management skills and support services; tailored risk transfer… more
- NTT DATA North America (MO)
- …the timelines to complete compliance training of NTT Data/Client * Work independently to research , review and act on the claims * Prioritize work and adjudicate ... the candidate will be responsible for:** + Processing of Professional and Hospital claim forms files by provider +...98.5% PA and 99.75% FA. * Timely response and resolution of claims received via emails as… more
- UCLA Health (Los Angeles, CA)
- …fee schedule and pricing methodologies for outpatient/inpatient institutional, ancillary, and professional claims + Experience processing complex institutional ... timely data entry, and the review and adjudication of professional , ancillary, and institutional claims for services...and turn-around requirements. This role requires the ability to research and resolve complex claim issues as well as… more
- NTT DATA North America (St. Louis, MO)
- …the timelines to complete compliance training of NTT Data/Client + Work independently to research , review and act on the claims + Prioritize work and adjudicate ... the candidate will be responsible for:** + Processing of Professional claim forms files by provider + Reviewing the...98.5% PA and 99.75% FA. + Timely response and resolution of claims received via emails as… more
- NTT DATA North America (St. Louis, MO)
- …the timelines to complete compliance training of NTT Data/Client * Work independently to research , review and act on the claims * Prioritize work and adjudicate ... to work **remote (MO).** **Role Responsibilities:** * Processing of Professional claim forms files by provider * Reviewing the...98.5% PA and 99.75% FA. * Timely response and resolution of claims received via emails as… more
- NTT DATA North America (MO)
- …the timelines to complete compliance training of NTT Data/Client -Work independently to research , review and act on the claims -Prioritize work and adjudicate ... team for a remote position. **Role Responsibilities** -Processing of Professional claim forms files by provider -Reviewing the policies...above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as… more
- NTT DATA North America (Dallas, TX)
- …the timelines to complete compliance training of NTT Data/Client + Work independently to research , review and act on the claims + Prioritize work and adjudicate ... the candidate will be responsible for: + Processing of Professional and Hospital claim forms files by provider +...98.5% PA and 99.75% FA. + Timely response and resolution of claims received via emails as… more
- CDPHP (Albany, NY)
- …invites you to be a part of that experience. The Risk Adjustment Claims Analyst will be responsible for identifying, interpreting, auditing and analyzing various ... encounter data and identifying areas of opportunity as it relates to claims processing and encounter submission. They may be required to prepare supplemental drill… more
- Sharp Electronics Corporation (Downers Grove, IL)
- **Overview** The Claims Specialist position is responsible for Point of Sale (POS) data management and processing back-end pricing rebates/credits, including ... resolution of issues/disputes in a timely and accurate manner....errors, correct any inaccuracies in POS daily. + Investigate, research , and identify business entities with minimal information provided.… more
- Trinity Health (Livonia, MI)
- …Ability to troubleshoot problems and questions from end users and provide resolution and requested information. Ability to research , evaluates, and analyzes ... simultaneously and adapts to frequent changes in priorities. Actively pursues professional growth opportunities. Utilizes support staff appropriately and adopts new… more
- UCLA Health (Los Angeles, CA)
- …exciting new direction. You can do all this and more at UCLA Health. The Claims Quality Auditor serves as the primary point of contact for submission and ... resolution of Provider Dispute Resolutions and Appeals. They will...documentation for tracking PDR/Appeals data and conduct all pertinent research to evaluate, respond and close incoming Appeals from… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Financial Representative- Oncology Claims Follow-Up/Billing Corporate Full-Time Days** Analyses accounts and billing(s) to ensure accurate ... Telephones contacts to follow up on accounts in a professional and assertive manner + Answers all patient, third...a timely manner, to immediate supervisor for handling or resolution + Utilizes trial balance and other reports to… more