- Humana (Denver, CO)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve ... settlements both for and against the organization. The Claims Research & Resolution Representative 2 performs varied activities and moderately complex… more
- State of Colorado (Denver, CO)
- Industrial Claims & Appeals Office: Administrative Law Judge II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4501115) Apply Industrial ... Claims & Appeals Office: Administrative Law Judge II Salary...which includes review of the transcript of hearings; legal research into the specific issues involved. + Draft a… more
- State of Colorado (Lakewood, CO)
- …current experience performing reviews/analysis of complex manufacturing and industrial utility tax claims + Problem solving, critical thinking, research , and a ... serving as specialists in specific industries and are assigned claims which are significant in size and data from...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Denver, CO)
- …unpaid), and/or (C) investigation, litigation, or other similar forms of dispute resolution (eg, arbitration or complex administrative claims or investigations) ... flexibility, the ability to analyze a large volume of claims and data, and stellar time management skills. Additionally,...documents/information; whether, when, and how to pursue a negotiated resolution ; and where a violation is found, what relief… more
- HealthEdge Software Inc (Denver, CO)
- …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... as escalation point for critical client needs aswarranted. + Lead diagnosis and resolution of escalated and more involved/complex client problems and issues. + Act… more
- Intermountain Health (Brighton, CO)
- …Uses knowledge of insurance plans and contractual arrangements affecting payments, to research incomplete, incorrect or outstanding claims and/or patient issues. ... and resolves claims submission, disputes or complaints to resolution , as needed. Resolves billing/insurance issues and ensures compliance with departmental… more
- State of Colorado (Denver, CO)
- …to resolve disputes in any of the following areas: + Handling of claims , policy services, compliance, and/or member services. Document this experience in your ... rules, policies, and procedures; + Demonstrated ability to conduct research and gather pertinent information; + Self-starter, including the...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- BrightSpring Health Services (Longmont, CO)
- …maximizing costs and minimizing expenses? OurCollections Analystsare responsible for the research , collection and/or resolution of an assigned account portfolio ... billing and resident information and in re-billing and resolving unpaid claims through adjudication + Works with Facility Collection Director/Manager/Supervisor and… more
- Cardinal Health (Denver, CO)
- …needs of the patient and/or program * Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance ... based upon region and ensure proper communication of the resolution within required time frame agreed upon by the...region with the appropriate team * As needed conduct research associated with issues regarding the payer, physician's office,… more