- Molina Healthcare (Tacoma, WA)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... Standard Operating Procedures (SOPs). * Responds to provider correspondence related to claims recovery requests and provider remittances where recovery … more
- Molina Healthcare (Tacoma, WA)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... and State regulatory requirements are met for Pre-pay Edits, Overpayment Recovery which improves encounter submissions, reduces General and Administrative expenses… more
- Molina Healthcare (Tacoma, WA)
- …review to facilitate a referral to law enforcement or for payment recovery . **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical ... records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines,...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more
- Molina Healthcare (Seattle, WA)
- …(specialty and ancillary) contracts highly desirable. **STATE SPECIFIC REQUIREMENTS** : Certified Recovery Peer Specialist certification required in the state of ... **_ Remote and must live in Washington _** **Job...and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple … more