- Trinity Health (Farmington Hills, MI)
- …and variances, make corrections, and take appropriate corrective action to ensure timely claim resolution . + Proactively follows up on payment delays and ... offs, transfers, allowances, and reversals. + Makes recommendations regarding complexity of claim resolution and the appropriateness of transferring account to… more
- Trinity Health (Farmington Hills, MI)
- …as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues upon hire and as new systems and processes ... and variances, make corrections, and take appropriate corrective action to ensure timely claim resolution . + Proactively follows up on payment delays and… more
- NJM Insurance (Hammonton, NJ)
- Job Description The Claim Resolution Specialist 1 will be responsible for contacting all parties involved in the claim , gathering, and securing all ... action plan to manage the claim . The Claim Resolution Specialist 1 will...NJM Legal to control legal expenses and assure effective resolution of claims to reduce aged inventory… more
- Acosta Group (Tampa, FL)
- …les resultats bases sur des mesures pour les clients et les detaillants. The Claims Resolution Specialist is responsible for validating and clearing ... **RESPONSIBILITIES** + Trains and mentors Claim associates on validating and clearing claims...with Acosta, client and customer policies and procedures. The Claims Resolution Specialist will communicate… more
- Penn Medicine (Philadelphia, PA)
- …the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution . Responsibilities: + Responsible ... Are you living your life's work? Job Title: Accounts Resolution Specialist I Department: Oral Surgery Location:...position will work out of assigned work queues handling claim edit work queue resolution as well… more
- Prairie Ridge Health (Columbus, WI)
- Prairie Ridge Health is seeking a Claims Resolution Specialist to join the Business Services team. This position is a 1.0 FTE (40 hours per week) and works a ... Monday-Friday, day shift schedule. The Claims Resolution Specialist is responsible...various health insurances, including knowledge of hospital and professional claim forms required. + Experience with revenue codes, CPT,… more
- Penn Medicine (Philadelphia, PA)
- …expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution . They may assist with ... Are you living your life's work? **Job Title:** Accounts Resolution Specialist II **Department:** OTO Admin **Entity:**...PBO. This position will investigate and follow up on claim edits and work denials and underpayments by insurance… more
- Centene Corporation (Cheyenne, WY)
- …offering competitive benefits including a fresh perspective on workplace flexibility. Senior Pharmacy Resolution Specialist - Remote - 12pm - 8:30pm (EST) M-F ... **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject...outbound calls with members and provider offices to provide resolution to claims (ie: additional information requests… more
- Pilgrim's (Greeley, CO)
- Accounting Resolution Specialist Purpose and Scope/General Summary: We are looking for an Accounting Resolution Specialist for Pilgrim's who responds to ... and plants via phone and email. + Investigate root cause of claims /deductions (transportation, plant, sales, customer error etc.) + Acquire required documentation… more
- MaineGeneral Health (Waterville, ME)
- …Come be with us. Job Description: Join Our Team as an Accounts Receivable Resolution Specialist The Opportunity: This role presents an exciting opportunity to ... as per departmental and payer guidelines. Review and edit claims for accuracy before submission to payers, ensuring the...the correct diagnosis and procedure codes are used. + Claim Resolution : Review and address claim… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …professional cultureExperience with Salesforce preferredBilingual- Spanish preferred Dividend Loan Resolution Specialist LOCATION -- Cincinnati, Ohio 45227 Fifth ... banking at Fifth Third Bank. GENERAL FUNCTION: The Loan Resolution Specialists work hand-in-hand across multiple departments including legal,...that spans more than 150 years. We've staked our claim on looking at things differently to make banking… more
- University of Virginia (Charlottesville, VA)
- The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities ... from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and...insurance companies, patients and the departments to ensure the claims are processed and followed up to meet the… more
- Bob's Discount Furniture (CT)
- …individuals who respond to concerns relative to furniture purchases, deliveries and warranty claims . The Customer Support Supervisor ensures that his or her own work ... is in compliance with applicable laws, regulations and guidelines, as detailed in policies located on the Company intranet. As a member of our Customer Support team, they must display a positive attitude and a passion for helping our internal and external… more
- Kepro (Tallahassee, FL)
- …partner for health Acentra Health is currently looking for Adjustment & Resolution Representative with experience in Claims /Billings to join our Tallahassee ... an opportunity to become diverse in a variety of claim types as you grow with our team! *Candidate...of bills. + Make appropriate bill adjustment into the claims system according to contractual requirements and timelines +… more
- Defense Logistics Agency (Philadelphia, PA)
- …Excellence (PaCE) Program performing a series of progressively responsible General Supply Specialist ( Resolution Specialist ) functions, along with formal and ... Conditions of Employment Qualifications To qualify for a General Supply Specialist , your resume and supporting documentation must support: A. Specialized Experience:… more
- TEKsystems (San Antonio, TX)
- …Genesis and the billing system are consistent and/or agree * Communicate with Resolution Specialist regarding billing issues * Verify control totals and item ... customer service, call center, health care, medical billing, medical claims processing, collections medical, government billing Top Skills Details: billing… more
- The Hartford (Hartford, CT)
- …we help shape the future. The Claim Specialist is the highest claim handling designation within the Complex Claims Unit - Construction (CCU-CD) and is a ... Specialist Claims - CH07DE We're determined...a well-reasoned analytical focus, and a clear strategy for resolution . The Claim Specialist must… more
- The Hartford (Penn, PA)
- …as we help shape the future. The Claim Specialist is the highest claim handling designation within the Complex Claims Unit - Bodily Injury (CCU BI) and ... Specialist Claims - CH07DE We're determined...a well-reasoned analytical focus, and a clear strategy for resolution . The Claim Specialist must… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist . This is a full-time position and offers a hybrid schedule after ... plan to manage the claim to final resolution . The Complex Claim Specialist ...policyholder's reporting practices + Prepare, attend, and participate in Claim Reviews as needed with the Claims … more
- Entergy (Russellville, AR)
- …the RFx processes, supporting supplier negotiations, and providing supplier management support for claims , invoice resolution , etc. The specialist will have ... Site Procurement Specialist (Nuc) **Date:** May 8, 2024 **Location:** Russellville,...with stakeholders to analyze and develop company position on claims and disputes; + Establish/maintain relationships with suppliers/partners, based… more