- Zurich NA (Schaumburg, IL)
- …124155 Zurich North America is seeking a sharp, solutions-driven Workers' Compensation Litigated Claims Specialist II to join our high-performing team. This ... the loss falls within the coverage. + Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- …Paralegal Specialist I, may progress non-competitively to a Paralegal Specialist II position, NF-04B, upon the completion of qualification requirements ... with less than 2 years in the current position. Incumbents selected at the Paralegal Specialist II m ay progress non-competitively to PD#0120 NF-04 (SC 4C) upon… more
- Baptist Memorial (Memphis, TN)
- …Summary * Position may be filled in Memphis, TN; Jackson , MS The Denial Mitigation-Appeal Specialist II RN serves in a key role of the BMHCC revenue cycle as ... collaborate with coding/billing for formulation of appeal with corrected claims and denial resolution in order to...in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received… more
- Baptist Memorial (Memphis, TN)
- …Summary * The position may be filled in Memphis, TN; Jackson, MS The Denial Mitigation-Appeal Specialist II RN serves in a key role of the BMHCC revenue cycle as ... collaborate with coding/billing for formulation of appeal with corrected claims and denial resolution in order to...in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received… more
- Community Health Systems (Birmingham, AL)
- …research to facilitate claim resolution and maximize collections. The Billing Specialist II also supports team training, assists with audits, and ensures ... loan assistance for eligible roles. **Job Summary** The Billing Specialist II is responsible for managing complex...companies, payers, and patients regarding billing inquiries and claim resolution . + Reviews and processes insurance claims ,… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- …experience demonstrated by NF-04/4C Contact Specialist I or NF-04/4D Contract Specialist II . Incumbent selected at the lower level may progress ... non-competitively to a Facility Contract Specialist II position, NF-04/4D, upon the completion of qualification requirements and training within a 2-year… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II (MCLA) Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... 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 Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary… more
- UIC Government Services and the Bowhead Family of Companies (Quantico, VA)
- **Overview** SERVICE DESK SPECIALIST | TIER II (MIELS): Bowhead is seeking Service Desk Specialists to support a customer in Stafford, VA. Support for the ... 24/7 support, including nights, weekends, and holidays, with timely issue resolution . + Assist in maintaining and administering Windows servers, workstations,… more
- AIG (Atlanta, GA)
- …investigate, evaluate and resolve Commercial General Liability and Auto Liability claims . Provides exceptional customer service and commitment to bring assigned ... cases to a timely, proper resolution . This requires accurate and thorough documentation, as well...upon the applicable law, coverage and supporting evidence. Assigned claims typically consists of medium to moderate complex litigated… more
- BD (Becton, Dickinson and Company) (Four Oaks, NC)
- **Job Description Summary** The Quality Specialist II is a senior-level role responsible for overseeing and enhancing quality systems, managing complex ... a focus on minimizing Zero Escape incidents. + Oversee intracompany claims and drive the resolution process. + Conduct and handle QMS Audits, ensuring rigorous… more
- Cedars-Sinai (Los Angeles, CA)
- …our care the most. **Req ID** : HRC1268782 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business Entity** : ... performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating… more
- Nuvance Health (Danbury, CT)
- …and accounts receivable functions.i? 1/2i? 1/2Responsible for the assigned areas' claims submission, payment application, denial management, and account follow-up to ... efficiency & reimbursement; includes accurate & timely preparation/submission of claims , payment & rejection application & follow-up for reimburse receivables.… more
- Grifols Shared Services North America, Inc (Research Triangle Park, NC)
- …upgrades, enhancements, and patches and assists with system updates. The Government Contracting Specialist II is able to perform these tasks with minimal ... Responsible for working with large amounts of data; evaluates claims level detail to ensure product dispensing aligns with...required. This knowledge is required for a Government Contracting Specialist II . + Experience with government rebates… more
- Guthrie (Sayre, PA)
- …and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, ... payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy,...2. Works closely with a Denial Resolution Specialist or Billing Specialist II … more
- Ellis Medicine (Schenectady, NY)
- The Medical Coder II is responsible for the revenue cycle activities of specific physician practices of Ellis Medical Group (EMG). This includes but is not limited ... and related work lists to ensure complete, timely and accurate submission of claims , (3) facilitating the accuracy and completeness of the practice's codes and… more
- Billings Clinic (Billings, MT)
- …to learn more! HIM Coder I or II FINANCE (Billings Clinic Main Campus) req9930 Shift: ... and certification, may qualify for a Level I or II HIM Coder Responsible for coding and abstracting diagnoses...* Ensures data accuracy prior to billing interface and claims submission. (ie, discharge disposition, appropriate use of modifiers,… more
- PPL Corporation (Lexington, KY)
- …conflict resolution skills required. + ISA Certified Arborist Utility Specialist , Certified Commercial Pesticide Applicators License a plus but not required. + ... conflict resolution skills required. + ISA Certified Arborist Utility Specialist , Certified Commercial Pesticide Applicators License a plus but not required. +… more
- Commonwealth Care Alliance (Boston, MA)
- …Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is responsible for ensuring CCA's operational compliance with ... 011250 CCA- Claims Position Summary: Reporting to the Director, ...or non-compliance. * Track internal audit findings and facilitate resolution through Corrective Action Plans (CAPs). Audit Readiness &… more
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