- Humana (Raleigh, NC)
- …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
- UNC Health Care (Chapel Hill, NC)
- …a variety of complex duties, including but not limited to, working outstanding insurance claims follow up for no response from payors, and/or claim denials. + Works ... physician claims ("professional billing"). + Maintains A/R at acceptable aging...through charge corrections, payment corrections, write-offs, other methods. + Research medical records to gather information and substantiate medical… more
- UNC Health Care (Raleigh, NC)
- …of complex duties, including but not limited to, working outstanding insurance claims having no response from payors, having claim edits, and/or having received ... denials. Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims and denied claims . Review credit balances for possible reallocation or… more
- UNC Health Care (Durham, NC)
- …to obtain authorizations and referral approvals for services and procedures. Research medical records to gather information and substantiate medical justification ... May serve as a lead worker to provide problem resolution and assistance to lower level positions. 6. Obtain...Post payments and denials to patient accounts, reconcile accounts, research and resolve a variety of problems relating to… more
- Revlon (Oxford, NC)
- …serve and maintain brand loyalty. Collects pertinent data for post marketing research , quality assurance reviews, and consumer behavior analysis. **Major Duties:** + ... Identify and assess consumer needs and select the proper resolution in a timely, friendly, and professional manner. + Follow proper procedures and guidelines as… more
- HealthEdge Software Inc (Raleigh, NC)
- …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
- UNC Health Care (Raleigh, NC)
- …effectively manage their teams in alignment with organizational plans. 2. Design, research , develop and implement HR initiatives to support people strategies, using ... issues where specific business area knowledge is essential. 6. Maintain a representative caseload involving a wide range of employee relations issues including… more
- Cardinal Health (Raleigh, NC)
- …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