- 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 necessary ... an action plan to manage the claim. The Claim Resolution Specialist 1 will work with and...NJM Legal to control legal expenses and assure effective resolution of claims to reduce aged inventory… more
- Penn Medicine (Philadelphia, PA)
- …our future each day. Are you living your life's work? Job Title: Accounts Resolution Specialist II Department: OTO Admin Entity: CPUP Location: Hospital ... St Hours: Full time regular Summary: + The Accounts Resolution Specialist II reports to...denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim… more
- AON (Fort Wayne, IN)
- Underwriting Specialist II K&K Insurance is a leading provider of specialty coverage in the exciting areas of sports, leisure, recreation, motorsports and ... choose K&K for our unique insurance products and expert claims resolution . As part of an industry-leading...What the day will look like As an Underwriting Specialist II , you will report directly to… more
- LA Care Health Plan (Los Angeles, CA)
- Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals Department: Claims Integrity Location: Los ... that purpose. Job Summary The Coordination of Benefits (COB) Validation Specialist ensures the accurate coordination of healthcare benefits for individuals covered… more
- Methodist Health System (Dallas, TX)
- …resolving no response claims , denied claims , and correspondence. As an AR II Specialist , you will play a crucial role in optimizing revenue flow by ... **Your Job:** We are seeking an experienced Accounts Receivable II (AR II ) Specialist specializing...the ability to identify patterns, trends, and discrepancies in claims and financial data. - Effective communication and interpersonal… more
- MyFlorida (Tallahassee, FL)
- REGULATORY SPECIALIST II - 79000511 Date: Apr 18, 2024 Location: TALLAHASSEE, FL, US, 32399 The State Personnel System is an E-Verify employer. For more ... 827713 Agency: Business and Professional Regulations Working Title: REGULATORY SPECIALIST II - 79000511 Pay Plan: Career...an escalation referral when further action is necessary for resolution . Duties include but are not limited to: +… more
- CareOregon (Portland, OR)
- …Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Benefit Specialist II Job Code A133 Department Pharmacy Manager Title Pharmacy ... medical benefit. + Follow policies and procedures to determine a resolution to pharmacy claims adjudication issues or triage to other CareOregon staff for… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training...additional service needs according to specific program guidelines. Uses claims processing and care management software to look up… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY:* * * The Revenue Cycle Specialist II will be responsible for the review, minor analysis, trending and follow up of Third Party Claims ... to include the identification, billing and collection of payments. The Revenue Cycle Specialist II will actively engage with other departments to ensure timely… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically necessary… more
- Beth Israel Lahey Health (Burlington, MA)
- …helps to resolve callers' issues, retrieving critical information that impacts the resolution of current or potential future claims . 3. Establishes relationships ... Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and...Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 1-2 years of… more
- Boardwalk Pipeline Partners (Houston, TX)
- Sourcing Specialist I/ II /III/Sr Houston, TX, USA Req #1231 Tuesday, March 26, 2024 *To access Dayforce at its best, log in from the latest version of Chrome, ... atwww.bwpipelines.com . We are currently looking for a Sourcing Specialist I/ II /III/Sr for our Houston, TX office....procedures to expedite or coordinate deliveries. + Facilitate the resolution of disputes and claims . + Address… more
- Guthrie (Sayre, PA)
- …spreadsheets, creates and runs reports as needed to be used in the resolution of outstanding claims (ex. trending, projects, worklists) Identifies trends and ... Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a...required and requested. Works with insurance payers on problem claims and processes. Resolves outstanding Accounts Receivable and credit… more
- Cedars-Sinai (Torrance, CA)
- …in other revenue cycle functions and provide back-up coverage. The Revenue Cycle Specialist II : + Participates in department meetings and provides feedback to ... and courteous demeanor. **Req ID** : 1194 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business Entity** :… more
- Intrepid USA (Bartlett, TN)
- …individuals in the Agency in a timely manner. We are looking for an Support Specialist II who is highly organized and detail-oriented with the ability to ... acquisition, recruiting process and team members As a Support Specialist , you will be responsible for non-clinical areas of...as needed + Completing Key Performance Indicators reporting and resolution on a daily basis: . RAPs Reporting .… more
- Cedars-Sinai (Torrance, CA)
- …Professional and courteous demeanor. **Req ID** : 1640 **Working Title** : Revenue Cycle Specialist II **Department** : CSRC PB - Group **Business Entity** : ... performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating… more
- Cedars-Sinai (Los Angeles, CA)
- …our care the most. **Req ID** : HRC1268782 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business Entity** : ... performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating… more
- Williams Companies (Houston, TX)
- …+ Coordinates communication between internal customers and vendors + Facilitates the resolution of disputes and claims + Supervises required inspections, ... you can too, so bring your energy to ours. As a Supply Chain Specialist III, you will apply fundamental judgment and evaluation to support our procurement processes… more
- Centene Corporation (Jefferson City, MO)
- …Documents and addresses customer complaints and issues (Ie, grievances, appeals, Claims Tracking Module) based on regulatory requirements. Supports and collaborates ... of complaints and issues to determine root cause and identify appropriate resolution + Collaborates with internal stakeholders to ensure timely and effective … more