- Mount Sinai Health System (New York, NY)
- …and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. ... **Job Description** The Procedural Billing Specialist I is responsible for multiple components of...specialized procedures, including Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing… more
- UPMC (Pittsburgh, PA)
- UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected ... Virginia workers comp adjuster license. The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims … more
- Commonwealth Care Alliance (Boston, MA)
- …certifications **Required Experience (must have):** + 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. + Experience ... 011250 CCA- Claims **_This position is available to remote employees...subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and provider engagement… more
- Billings Clinic (Billings, MT)
- …Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Claims Specialist I/Government (Full-time) ... claims from government and third-party payers. The Claims Specialist is responsible for preparing and...responsible for appropriate follow up on all accounts pending payment from government and third-party payers. Essential Job Functions… more
- HCA Healthcare (Kissimmee, FL)
- …NH, NC, SC, TN, TX, UT, VA). Do you have the career opportunities as a Claims Resolution Specialist you want with your current employer? We have an exciting ... a committed, caring group of colleagues. Do you want to work as a Claims Resolution Specialist where your passion for creating positive patient interactions is… more
- ICW Group (TX)
- …everyday! Learn more about why you want to be here! **PURPOSE OF THE JOB** This Claims Specialist is responsible for handling complex claims with a focus on ... to an equitable resolution within Company standards. The Claims Specialist works with a sense of...and appropriate benefits to injured workers; manages and approves payment of benefits within designated authority level. Works within… more
- Commonwealth Care Alliance (Boston, MA)
- …(CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment methodologies + ... 011250 CCA- Claims Hiring for One Year Term **_This position...coding logic, related Medicare/Medicaid policies for review/approval through the Payment Integrity governance process. **Supervision Exercised:** + No, this… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Research Specialist will oversee and manage research efforts related to claims overpayments, underpayments, ... and working collaboratively with providers and internal departments to enhance claims processes and improve financial outcomes. **Essential Functions:** - To… more
- University of Washington (Seattle, WA)
- …Medicine Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is ... responsible for claims review, clearing claim edits, and timely and accurate...rejections, or forwarding the claim to a medical coding specialist for review and coding changes prior to submitting… more
- Molina Healthcare (Kearney, NE)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with… more
- Carrington (Augusta, ME)
- **Come join our amazing team and work remote from home!** The Claims Recovery & Loss Analysis Specialist is responsible for performing financial reconciliation ... and problems including, but not limited to, claim denials/curtailments and claim payment offsets. + Moderate working knowledge of all Default Servicing processes up… more
- CDM Smith (Albuquerque, NM)
- …process. * Performs other duties as assigned. \#LI-LP2 **Job Title:** FEMA Claims Specialist **Group:** WAF Field Mod Fringe **Employment Type:** Temporary ... for two years in developing policy, procedures, and processing claims in support of the Hermit's Peak Calf/Canyon fire....from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or written commitments from… more
- Modernizing Medicine (Phoenix, AZ)
- …for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections + Initiate outbound ... Chile, and Germany. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient… more
- Guidehouse (San Marcos, CA)
- …Required** **:** None **What You Will Do** **:** The **Cash Applications Specialist ** - Under general supervision and according to established policies and ... procedures, performs a variety of duties related to the payment posting function of the Management Services Organization (MSO)....satisfy the customer's perceived needs. **Duties and Responsibilities** + Payment prep and posting. + Sign out for … more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to blue. Reporting to the Director of Professional Reimbursement Strategy, the Payment Integrity Consultant uses industry knowledge, research skills, payment ... prioritizing development needs and requirements + Participate in professional reimbursement payment integrity activities that include developing new payment … more
- Insight Global (Jacksonville, FL)
- Job Description The Payment Reconciliation Specialist is responsible for deposit and remittance capture, payment posting and reconciliation processes. The ... oversee outsourced labor -Communicate system setup changes to improve billing and payment posting -Manage remittance capture, payment posting, and deposit… more
- Queen's Health System (Honolulu, HI)
- …I. JOB SUMMARY/RESPONSIBILITIES: * Responsible for analysis of denied reimbursement claims , including conducting payment audits, creating reports and ... minimize and/or prevent denials. * Follows up on insurance claims with outstanding balances; leads meetings with payors to...with outstanding balances; leads meetings with payors to resolve payment and denial issues. * Writes and submits appeals… more
- East Boston Neighborhood Health Center (Revere, MA)
- …Summary: Under the direct supervision of the Patient Financial Services Director, the Payment Poster/EDI Specialist is responsible for the accurate and timely ... and posting of all incoming payments and rejections of payment from insurance companies, patients, and third party payers...adjustments as necessary to ensure proper filing of supplemental claims to insurance companies. The staff in this position… more
- CDPHP (Latham, NY)
- …diploma or GED required. + Minimum of one (1) year experience in health care claims review and adjudication to payment /denial utilizing CPT-4, ICD 10 and HCPCS ... these values and invites you to be a part of that experience. The Claims Representative shall assume full responsibility and ownership for all aspects regarding … more
- Stony Brook University (Commack, NY)
- …completeness and compliance with WTCHP guidelines. Validating and releasing both internal and external claims . + Research claims for payment in the WTCHP ... Claims Processor **Required Qualifications (as evidenced by an...posting.** **Job Number:** 2504206 **Official Job Title:** : Clerical Specialist II **Job Field** : Clerical/Secretarial **Primary Location** :… more