- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred… more
- Commonwealth Care Alliance (Boston, MA)
- …certifications **Required Experience (must have):** + 3+ years in healthcare claims processing , provider reimbursement, or payment integrity. + Experience ... have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or...+ Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer… more
- Molina Healthcare (Rochester, NY)
- … claims issues. This role requires a keen understanding of medical claims processing , strong analytical skills, and the ability to effectively triage ... or team for further research or correction. + Leverages knowledge of claims processing workflows, billing practices, and regulatory guidelines to provide… more
- Pine Acres Rehabilitation & Care Center (West Des Moines, IA)
- …but not limited to accounts payable, Medicare A, B, and C billing, and Medicaid MCO billing and application processing . Business Office Manager Duties and ... to prepare billing of Medicare A, B, and C claims . + Collaborates with residents and responsible parties on...responsible parties on financial matters, such as applying for Medicaid . + Responsible for collection of private pay accounts… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** **Job Summary** Responsible for reviewing Medicaid , Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, ... tools such as DSHS and Medicare billing guidelines, Molina claims ' processing policies and procedures, and other...of 1 year experience in healthcare insurance environment with Medicaid , or Managed Care + Strong verbal and written… more
- Trinity Health (Farmington Hills, MI)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting or ... of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates… more
- NTT America, Inc. (Plano, TX)
- NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible ... MS-Excel. Preferred Skills & Experiences: * Amisys or Xcelys * Medicaid and Medicare Claims processing experience * Ability to communicate (oral/written)… more
- Humana (Tallahassee, FL)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Cheyenne, WY)
- …based on business needs. **Preferred Qualifications** + Bachelor's Degree + Prior claims processing experience + Overpayment experience + Financial recovery ... a part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve customer… more
- Dignity Health (Bakersfield, CA)
- …of complex healthcare claims . This position requires expert knowledge of claims processing , coding, and regulatory compliance. The Claims Examiner ... **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years...of CPT, ICD-10, HCPCS coding, and medical terminology. + Associate 's Degree - Associate 's Degree in healthcare… more
- Humana (Columbus, OH)
- …or team lead role. **Knowledge & Skills:** + Solid understanding of claims processing , insurance guidelines, and provider data interpretation. + Familiarity ... a part of our caring community and help us put health first** The Supervisor, Claims Review makes appropriate claim decision based on strong knowledge of claims … more
- ManpowerGroup (Marquette, MI)
- …Marquette, MI Pay: $16.32 per Hour What's the Job? - Accurately process Medicaid claims in compliance with policies and regulatory guidelines. - Maintain ... - Meet or exceed production and quality goals for claims processing . - Assist with training new...unpaid lunch. - Required: High school diploma or GED ( Associate degree preferred). - Required: 1 year experience in… more
- Marshfield Clinic (Marshfield, WI)
- …come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP- Claims ... shifts (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround… more
- McLaren Health Care (Flint, MI)
- …specifications for all information systems, including benefiting and pricing requirements for claims processing . Develops and maintains reporting as needed by ... We are looking for a Claims Coding Specialist, to join us in leading...the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and… more
- Trinity Health (Davenport, IA)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting, or ... and professional behavior. **MINIMUM QUALIFICATIONS** High school diploma or Associate 's degree in Accounting or Business Administration and successful completion… more
- NTT America, Inc. (Plano, TX)
- …assessment **Preferences** Amisys &/or Xcelys Preferred "NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and ... MS-Excel. Preferred Skills & Experiences: * Amisys or Xcelys * Medicaid and Medicare Claims processing experience * Ability to communicate (oral/written)… more
- IQVIA (Wayne, PA)
- …issues. **Essential Functions and Responsibilities:** + Responsible for **pharmacy prescription claims processing ** , translating strategy into proactive plans ... Job Description Summary: ** Associate Director Finance Operations** Directs financial planning and...payees. + Identify and manage **payment data related to claims , rebill, and manage overrides.** + Audit readiness and… more
- KPH Healthcare Services, Inc. (Rochester, NY)
- …Care, and private billing, claim corrections and follow-up + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems ... **Overview** **Scope of Responsibilities** : The Administration Billing Associate is responsible for identifying, researching, rectifying, and maintaining accurate… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims . + Participates in the development and implementation of TPL ... systems and policy. + Minimum 2 years professional experience with liability insurance claims processing . + Minimum 1 year professional experience with CPT,… more