- Monster (Garden City Park, NY)
- Seeking a Certified Medical Coder with Operations Management experience to work in our HIM department. The HIM Operations Manager will plan, organize and manage the ... progressive healthcare management and business administration, Bachelors degree and Medical Coding Certification. Responsibilities: Evaluates the impact of innovations… more
- LAZ Parking (Santa Cruz, CA)
- …and existing employees. Address all safety concerns promptly. Profit Responsible for claims and safety related training, prevention initiatives, and claims ... guest follow-up, and compliant reporting. Responsible for overall financial success including audit compliance and ensuring the operation follows audit protocol.… more
- PharmaCord (Jeffersonville, IN)
- …and assurance experience preferred Previous healthcare experience strongly preferred Client Audit experience a plus. Knowledge of the specialty drug product ... marketplace, health insurance claims processing, and commercialization of products and working with...Increased competitive 401(k) company match up to 4% Affordable Medical , Dental, and Vision benefits - PharmaCord covers 75%… more
- Monster (Vienna, VA)
- …and respond to CFPB and BBB complaints Research and analyze claims /related actions; resolve issues Identify and address compliance issues; update guidelines ... and results Prepare ad hoc and required industry and regulatory reports including audit inquires in compliance with internal and external regulations Serve on teams… more
- Monster (Richmond, VA)
- …Assist the Project Teams in maintaining, updating, and monitoring the CPM schedules. Audit project schedule(s) and alert the project team to potential problem areas. ... Impact Analysis (TIA) and assist in the development of change orders and claims . Generate forecasts, variance reports, and other documentation used to monitor and… more
- TEKsystems (Tampa, FL)
- …appeals specialist, insurance follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit , appeals process, appeals letter, ... possible) 1. Heavy Research - will be assigned an audit of varying volume of accounts will either be...phone to communicate and solve problems - determine why claims are denied - determine where to send appeals… more
- LogixHealth (Dania, FL)
- Location: On-Site in Dania, FL This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We offer a… more
- AnMed Health (Anderson, SC)
- …to account information. Prepares and files electronically or hard copy claims . Stays current of all Government/State/HIPPA, etc., rules and regulations pertaining ... Care, rules, and regulations governing billing compliance. + Gather and analyze medical records and billing for insurance payer audits. + Responsible for quarterly… more
- International Medical Group (Indianapolis, IN)
- …hospital, and other insurance companies; initiating or conducting investigation of questionable claims . + Documents medical claims actions by completing ... ; documenting actions; maintaining their imaging queues; maintaining quality audit standards and ensuring their outcomes are following the...values. QUALIFICATIONS + At least 1 year of prior medical claims processing experience OR willing to… more
- Guidehouse (El Segundo, CA)
- …is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other ... any and all related job duties as assigned. **_The medical biller will be working a Hybrid schedule based...Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides… more
- Kelly Services (Glastonbury, CT)
- **Job Title:** **Bilingual** Medical Claims Processor / Medical Claims Specialist **Pay Rate:** $24.00 + /hour (Depending on exp) **Schedule:** 11:30 AM ... We are currently seeking a detail-oriented, organized, and compassionate ** Medical Claims Processor / Medical ...accurate financial records and assist with batch processing + Audit outgoing payments for accuracy and compliance + Manage… more
- CHS (Clearwater, FL)
- … claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing… more
- WTW (Chicago, IL)
- …PPO, Indemnity and Managed Care + Must demonstrate a high level of claims administration knowledge, including experience with medical , dental, mental health and ... **Description** As a Lead Auditor you will apply your audit , project management and client management skills to lead client audits. You will serve as the team leader… more
- Sedgwick (Sacramento, CA)
- …in audit exceptions. + Reviews and updates notes/diaries in claims management system as instructed. + Coordinates jurisdictional training on state specific ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Services Associate | Hybrid | Sacramento, CA Are you looking for an… more
- CHS (Clearwater, FL)
- … and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer ... Duties and Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for claims … more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Claims Research and Resolution Professional 2 reports to the Claims Research and ... Resolution Lead and is responsible for tracking and trending Michigan Medicaid claims data and completing root cause analyses of claims denials or rework,… more
- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The Senior Claims Research and Resolution Professional reports to the Claims Research and Resolution ... Lead and is responsible for tracking and trending Michigan Medicaid claims data and completing root cause analyses of claims denials or rework, underpayments,… more
- Humana (Springfield, IL)
- …Humana Fully Integrated Dually Eligible (HMO D-SNP) in IL, is seeking a Claims Research & Resolution Professional claims educator, who will be responsible ... for carrying out Humana's proactive approach to minimize claims denials through claims education and training. The Claim Research and Resolution Professional… more
- American Water (Camden, NJ)
- …package including 401(k),Defined Contribution Plan, Employee Stock Purchase Plan, medical , prescription, dental and vision coverage, plus disability, paid time ... wastewater services to our communities. Effective, efficient, and intelligent insurance claims management, oversight, and forecasting are essential to this mission.… more
- Cardinal Health (San Juan, PR)
- … medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
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