- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …Shift Daytime Job Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment ... act as the point of contact for claim related research . Serves as a claims subject matter...expert (SME) and resource/support for claim edit and payment policy initiatives Conducts in-depth research on complex… more
- GAP SOLUTIONS INC (Herndon, VA)
- …Category Human Resources Description Position Objective: As a Junior Human Resource Specialist , apply HR skills in support of managers, program staff and customers ... classification, processing, benefits, recruitment, compensation, SES programs, work life programs, policy and employee and labor relations.In support of the Dept. of… more
- Defense Media Activity (Fort George G Meade, MD)
- …software and systems to maintain property control over inventory IAW industry, DoD policy , and DMA standards. Conducts market research and prepares procurement ... and remote location television productions. Duties Help As a AUDIOVISUAL PRODUCTION SPECIALIST at the GS-1071-11 some of your typical work assignments may include:… more
- Lincoln Financial (Denver, CO)
- …on financial calculations with team members that involve complex contract provisions. + Research questions and escalations from Claims team; liaises with various ... 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product...product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You… more
- UPMC (Pittsburgh, PA)
- …burden of cancer. UPMC Hillman Cancer Center is currently hiring a regular full-time Research Specialist - Coverage Analyst, ONC to help support the Oncology ... that should be covered by the study sponsor. The specialist collaborates with clinical research teams, finance...Policy and other payer regulations related to clinical research billing. + Applies the appropriate CDM and/or CPT… more
- Blue KC (KS)
- …assistance** **Employee discount program** **Job Description Summary:** The Medical Policy Nurse Specialist researches, coordinates, analyzes, and provides ... or equivalent + 5 years of related experience in research , Utilization Management, and medical policy work...Strong understanding of Blue KC core systems (including facets, Claims Xten **Blue Cross and Blue Shield of Kansas… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Senior Healthcare Data Analyst** **Job Class: Agency Policy Specialist ** **Agency: Human Services Dept** + **Job ID** : 89227 + **Location** : ... Intelligence software suite. + Experience working in health services research or health care policy . + Experience...Experience working with health care data systems, such as claims data or electronic health records. + Experience with… more
- The Cigna Group (Bloomfield, CT)
- …Behavioral Care Specialist /Advocacy role preferred + Experience handling behavioral health claims and provider relations calls is a plus + Ability to thrive in ... The Claims & PR Advocate is a **phone queue-based...or follow-up. + Use multiple applications during calls to research and resolve inquiries. **Call topics may include:** +… more
- Johns Hopkins University (Baltimore, MD)
- …to the claims submission process, either electronically or by paper. The Specialist will use a comprehensive knowledge of claims submission requirements for ... will be responsible for the collection of unpaid third-party claims and resolution of non-standard appeals, using various JHM...all payors in order to expedite payments. The Specialist will research and interpret medical policies… more
- Ventura County (Ventura, CA)
- Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply Medical Billing ... Specialist III/IV - Behavioral Health Salary $52,216.65 - $73,565.49...IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance… more
- Johns Hopkins University (Middle River, MD)
- …payer or contract. + Prepares appeals documentation and incorporates results of medical policy research and interpretation. + Resolves claim edits. + Research ... across different sub-specialties and/or relating to high-cost procedures. Will incorporate research findings on medical policy into appeals documentation.… more
- Methodist Health System (Dallas, TX)
- … claims , able to identify, address, and resolve no response claims , denied claims , and correspondence. As an AR II Specialist , you will play a crucial ... Description :** We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing to join our team at our Central Business… more
- USAA (Nashville, TN)
- …us special and impactful. **The Opportunity** As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, ... evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will...in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for… more
- Travelers Insurance Company (Houston, TX)
- …to join our Strategic Resolution Group Claim team as a Major Case Specialist handling complex toxic tort, latent injury, sexual misconduct, environmental claims ... will independently manage our most challenging high frequency and high severity claims and accounts which routinely present unique, complex liability and coverage… more
- Cedars-Sinai (CA)
- …that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the ... Hospitals! **What will I be doing in this role?** The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and… more
- Guthrie (Towanda, PA)
- …to insurance payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy, ie diagnosis and ... invoice is correct. Follows up with payers on unresponded claims . Works denied claims by following correct...in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects,… more
- Pfizer (Memphis, TN)
- …supply chain and customer operations team as necessary. + Research complex claims . Work collaboratively with customers , deduction specialist and the credit ... Business Objects application to review customer orders, analyze operational trends, and research customer reported issues. + Customer Account Specialist works… more
- Medtronic (Mounds View, MN)
- …Day in the Life** **POSITION DESCRIPTION:** The Principal Health Economics and Outcomes Specialist will be a critical leader in Surgical OU Statistics and Health ... Economics & Outcomes Research (HEOR) team. This role is responsible for providing...RWE (Real World Evidence) studies using administrative health care claims data, electronic health record data and other data… more
- New York State Civil Service (Albany, NY)
- …or laws to organizations, government or corporate officials, or individuals; policy analysis and research ; surveillance; quality assurance that included ... NY HELP Yes Agency Cannabis Management, Office of Title Program Specialist 1 (Cannabis) (NY HELPS) - VID 199546 Occupational Category Other Professional Careers… more
- Ventura County (Ventura, CA)
- Medical Billing Specialist II - Patient Financial Services Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4940099) Apply Medical Billing ... Specialist II - Patient Financial Services Salary $49,302.23 -...direction, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance… more
