- ACSC Management Services Inc (Providence, RI)
- …and statutory requirements, and technical and customer service Best Practices. Job Duties Review claim files regularly for quality. Track and monitor all ... statistical measures and behavioral indicators to evaluate Claims Reps performance (eg file review , audits,...and personal performance. Remarkable benefits: * Health coverage for medical , dental, vision * 401(K) saving plan with company… more
- Houston Methodist Primary Care Group (The Woodlands, TX)
- …blood pressure, weight, and height), chief complaint(s), preforms medication(s) review , discusses/reviews medical and social history (as appropriate). ... At Houston Methodist, the Multi-Site Senior Medical Assistant, (Multi-Site Sr. MA) position is responsible for working at multiple sites, within multiple specialties… more
- ACSC Management Services Inc (Providence, RI)
- …and third-party claims in multiple markets. Demonstrate proficiency with estimate review , material damage, liability, analysis of claims , claims ... Claims Auto Adjuster Job Summary This entry-level position...and individual performance. Remarkable benefits: * Health coverage for medical , dental, vision * 401(K) saving plan with company… more
- Aveanna Healthcare (Miami, FL)
- …Management/Issue Resolution * Plan and implement branch growth strategies * Thorough review of financial statements, activity reports, and other performance data to ... * Oversight if internal billing and collection efforts to generate clean claims * Perform other duties as assigned Benefits Offerings: 401(k) with company… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …Supports resolution of government contract issues and compliance with 340B regulations and review of MFP refund payments within the 14-day payment window to confirm ... PHS chargebacks and MFP rebates Ensure timely receipt of claim -level data, transmission of payment elements, and submission of...the Manufacturer elects to cease utilizing the MTF PM Review and verify credits and debits using Ledger System… more
- Sentry Insurance (Stevens Point, WI)
- …Extensive claims knowledge with ability to understand and manage litigated claims Ability to review and analyze complex documents, insurance policies, ... Evaluate and resolve complex subrogation claims in an efficient and accurate manner, developing...professionals to proactively identify subrogation opportunities early in the claim lifecycle. Stay ahead of emerging trends in subrogation… more
- Cipla (Hauppauge, NY)
- …to include a 401(k) savings plan and matching, health insurance - medical /dental/vision, health savings account (HSA), flexible spending account (FSA), paid time off ... on the approved materials, once release from quality control after testing. Review and verify artwork proofs for printed packaging materials to ensure accuracy,… more
- ACSC Management Services Inc (Coppell, TX)
- …claims within the unit meet or exceed quality and regulatory requirements. Regularly review appropriate claim files for quality and monitor results of all ... Casualty Claims Unit Manager - Litigation This role will...all employees and ensure decisions correlate with corporate and Claim Division goals. Communicate corporate, unit, and team goals… more
- PedIM Healthcare (Crystal River, FL)
- …professional development and training. Supportive and collaborative work environment. Responsibilities: Review and process medical claims for accuracy ... Florida. We are currently seeking a detail-oriented and experienced Medical Billing Specialist to join our team. If you're...data and resolve any discrepancies. Generate and submit insurance claims to payers promptly. Follow up on unpaid or… more
- Insmed Incorporated (NJ)
- …outcomes studies and clinical trial endpoint selection, disease natural history, medical claims and electronic health records, database analyses, economic ... collaborates with stakeholders across the company including market access, marketing, medical affairs, and clinical development to understand and support Insmed's… more
- Sentry Insurance (Davenport, IA)
- …of this role is conducting inspections on auto damage to prepare and review repair estimates. Additionally, you'll: Evaluate items such as labor costs, part prices, ... repair services to ensure estimates are accurately completed and fairly priced. Evaluate claim damages and calculate actual cash values for damaged items that may be… more
- Paradigm Oral Health (Lincoln, NE)
- …This role ensures accurate eligibility and benefit gather across dental or medical payers, clean pre-authorization and claim generation, timely insurance ... paper, or via portal) in accordance with payer-specific requirements and timelines. Review rejected claims , identify causes, and resubmit corrected claims… more
- UTMB Health (Galveston, TX)
- …investigative findings. Diagnoses and analyzes root causes of work environment issues. Review and assess data to identify and investigate areas of concern. ... by providing accurate and complete documentation and participating in unemployment claim hearings. Analyzes data to identify trends and develop interventions to… more
- ACSC Management Services Inc (Costa Mesa, CA)
- …standards across the unit. Key Responsibilities Audit Oversight & Quality Control Review and validate audit findings to ensure accuracy, consistency, and timely ... formal reports and presentations. Operational Excellence Ensure adherence to claims handling guidelines, regulatory requirements, and internal quality standards.… more
- Sentry Insurance (Salt Lake City, UT)
- …and the related items such as coordinating agency appointments, agency evaluation/ review and overseeing agency activity. Analyze quality and quantity of risks ... and works closely with management, Underwriting, Loss Control and Claims in determination of acceptability of the risk and...of the office as well as Volunteer-Time off Group Medical , Dental, Vision, Life insurance, Parental leave, and our… more
- StarKist Co. (Reston, VA)
- …back-up documentation from brokers, customers and/or carriers to validate claims . Resolves invalid or unauthorized deductions by following deductions procedures ... Maintain deduction tracking of all open and closed claim for assigned accounts. Monitor Accounts Receivable daily, identify and collect on past due balances, resolve… more
- Sonora Quest Laboratories (Phoenix, AZ)
- …as well as applicable professional standards. MINIMUM QUALIFICATIONS Two (2) years' medical claim collection experience with knowledge of insurance billing ... health! POSITION SUMMARY This position coordinates and facilitates all insurance claim submissions, claim rejections, account refunds, complex adjustments and… more
- Baggett Law (Jacksonville, FL)
- …with clients regularly to provide updates, set expectations, and gather information Review and analyze medical records, police reports, insurance policies, and ... Performance-Based Bonus Responsibilities: Evaluate and investigate new personal injury claims for merit and liability Manage a high-volume caseload...other case documents Coordinate medical treatment for clients and monitor progress Draft and… more
- RWJBarnabas Health Corporate Services (Oceanport, NJ)
- …forth by RWJBH, American Hospital Association (AHA) and the American Medical Association (AMA) must be maintained. Qualifications: Required: CCS required ... a Bachelor's degree. Extensive knowledge of ICD-10-CM/PCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with… more
- Unknown (Philadelphia, PA)
- …and plan modeling bill edits credentialing risk management health plan replacement medical networks care management & navigation utilization review disease ... Held Founded 2004 Employees 501-1000 Categories Insurance Specialties bill review out-of-network repricing primary ppo and alternative repricing administration edi… more
