- Acosta Group (Charlotte, NC)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- Lowe's (Mooresville, NC)
- **Your Impact** The primary purpose of this role is to serve as a high-risk claims analyst for the Legal department, handling high risks/high value cases and ... Claims Examiner + Serves in a supervisory capacity to other examiners on claims resolution + Develops and delivers training to be used for new claims … more
- Prime Therapeutics (Raleigh, NC)
- …our passion and drives every decision we make. **Job Posting Title** Recovery & Resolution Analyst **Job Description** The Recovery & Resolution Analyst ... accounts that are subject to collections; coordinate with Senior Recovery and Resolution Analyst to support driving collections activities conducted by a… more
- Robert Half Accountemps (Raleigh, NC)
- Description We are in search of a remote Revenue Cycle Analyst to join our team. In this role, your main function will be to manage revenue cycle processes which ... balances in a timely manner. * Conduct research on claims denials and complete adjustments accurately and promptly. *...of medical insurance policies and procedures, aiding in claim resolution . Robert Half is the world's first and largest… more
- Highmark Health (Raleigh, NC)
- …group administrators, brokers, and Agent Plan personnel to ensure the resolution of issues related to benefit interpretations, customer service inquiries, ... claims adjudication, benefits issues, membership and billing activity, etc....experience rated and community rated dental groups.The Client Benefit Analyst is responsible for providing or coordinating prompt support… more
- Highmark Health (Raleigh, NC)
- … claims processing problems, perform initial problem identification and resolution activities, and debug benefits and medical policy program coding. Document ... and scalability and reusability of benefit configurations. Develop and execute claims testing plan, scenarios, documentation and defect management to ensure minimal… more
- Highmark Health (Raleigh, NC)
- …requirements for member or provider issues; independently coordinates the resolution with internal/external parties as required; and documents and summarizes ... review all related relevant documentation and assemble case file. + Coordinate resolution results and relay investigative results with all involved parties. +… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be responsible for ... as well as managing day-to-day activities related to supporting core claims processing system configurations and changes. Primary Responsibilities + Establishes… more
- Highmark Health (Raleigh, NC)
- …progress and accuracy of work. + Provide technical leadership in first-line resolution of complex technical problems. + Provide Staff Management oversight. + Hire, ... of experience specific to the Dental Solutions Application Portfolio (eg, Concordia Claims Processing & RENO, Portal applications, UCD billing, etc.) may be… more