- Advocate Aurora Health (Charlotte, NC)
- …organizational standards and best practices. They are responsible for the adjudication of medical only claims and provides superior customer service to achieve ... some remote, work from home opportunity. The Workers Compensation Claims Analyst Assoc is a critical thinker who manages...be able to work independently. Must have familiarity with medical terminology Must be able to manage multiple tasks… more
- Berkley (Trenton, NJ)
- …loss claims experience Prior experience handling first dollar payer insurance ( medical healthcare claims ) Experience with medical billing practices, CPT ... Responsibilities We have an opportunity for a Stop Loss Claims Analyst to join our Berkley Accident and Health...claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim Review and… more
- Crawford and Company (Brea, CA)
- …the processing of the claim. Identifies wage loss expenses and wage exposures on medical claims . Documents receipt and contents of medical reports. Interacts ... up to, but not exceeding, $2,500 after compensability has been determined. Evaluates medical claims for potential fraud issues, loss control and recovery in… more
- NYC Health Hospitals (New York, NY)
- …a team of litigation associates who manage and handle a case load of complex medical malpractice claims filed against the largest municipal health care system in ... of the managing attorney and be expected to handle complex medical malpractice claims from inception through final resolution, including trials. Strong … more
- Public Risk Innovation Solutions and Management (Folsom, CA)
- …claims representatives. Maintain a caseload of open excess reportable Indemnity and Future Medical claims on a regular diary in an electronic claim file ... excess workers' compensation claims , consisting of complex and catastrophic claims (future medical and possibly indemnity claims at the Specialist level)… more
- USAA (Phoenix, AZ)
- …and impactful. The Opportunity It is all about learning and growing. Our Customer Service Claims Representative role may be a new career for you. Theres a lot to ... Phoenix office (1 Norterra Drive, Phoenix, AZ 85085) as a Customer Service Claims Representative. You will be part of an outstanding contact service center, where… more
- USAA (Phoenix, AZ)
- …and impactful. The Opportunity It is all about learning and growing. Our Associate Auto Claims Representative role may be a new career for you. Theres a lot to ... Phoenix office (1 Norterra Drive, Phoenix, AZ 85085) as a Customer Service Auto Claims representative. Your work will focus on adjusting non-injury auto claims … more
- Trinity Health (Farmington, MI)
- …care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or ... of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates… more
- BlueCross BlueShield of South Carolina (Columbia, SC)
- …procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non- medical appeals. Determines whether to return, deny or ... to resolve these inquiries. Other responsibilities include review and adjudication of claims and/or non- medical appeals, determining whether to return, deny or… more
- Chubb (Walnut Creek, CA)
- …Angeles, CA office. Duties & Responsibilities: Handles all aspects of workers' compensation medical only claims from set-up to case closure ensuring strong ... customer relations are maintained throughout the process. Review and assess new medical -only claims to determine eligibility and coverage under workers'… more
- Blue Cross Blue Shield of Arizona (Phoenix, AZ)
- …Services Division such including utilization management, quality management, case management, medical claims review, and pharmacy management. Specific activities ... regulatory compliance, care and disease management, concurrent review, precertification, medical claims reconsideration and retrospective review. Provide… more
- Insight Global (Los Angeles, CA)
- …systems in the country. This person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted with LA Care, ... (eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating...start on the 31st day of employment and include medical , dental, and vision insurance, as well as HSA,… more
- Medical Health Associates of Western New York (Buffalo, NY)
- …by performing a full spectrum of revenue cycle activities. Duties and Responsibilities: Claims Processing: Accurately process medical claims for submission ... full-time Billing Associates to join our team at the Medical Health Associates of WNY (MHA). MHA is the...or missing information. Resolve any issues or discrepancies with claims , working closely with insurance companies, healthcare providers, and… more
- On Point Staffing Group (Little Falls, NJ)
- …and accurate payment from insurance providers. Key Responsibilities: Manage and process medical insurance claims to guarantee timely payments. Analyze and ... Join our dynamic team as a Medical Insurance Accounts Receivable Specialist, where your expertise...Craft compelling appeals to secure payments on initially denied claims . Preferred Qualifications: A minimum of 3 years of… more
- Westchester Medical Center (Valhalla, NY)
- …of clerical experience, one year of which included the processing of patients' medical insurance claims as the primary function of the position. Substitutions ... is no substitution for the one year of specialized experience processing patients' medical insurance claims . *Special Note: Education beyond the secondary level… more
- Solugenix (Los Angeles, CA)
- …for various tasks within the Financial Compliance Unit, including the audit of claims processed by medical groups and health plans contracted with client. ... issues and findings that would affect the audit results. Perform claims audits for all medical groups and health plans contracted with client. Timely audit… more
- AUROBINDO (Durham, NC)
- …resumes, conducting phone screens, and interviewing.Assist with benefits administration including medical , dental, vision, COBRA and 401(k), health and welfare open ... (FMLA, STD, etc.), Visas and Immigration (H1B, L1, etc.), Workers Compensation claims , Unemployment Claims , etc.Committee member for all employee activities… more
- Trinity Health (Chelsea, MI)
- …insurance, or managed care industries is highly preferred. Experience performing medical claims processing, financial counseling and clearance, or accounting ... for claims processing and maintenance of an accurate electronic medical record. Registers and checks-in patients and determines preliminary patient and insurance… more
- Trinity Health (Farmington, MI)
- …care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or ... customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred. Previous service/call center experience with the ability to respond to customer inquiries and expectations in a… more
- American Recruiting and Consulting Group (Jacksonville, FL)
- …Determinations (LCDs) and ensuring compliance with Medicare policies, reviewing medical claims , and promoting evidence-based healthcare. ESSENTIAL DUTIES ... and external stakeholders. * Provide the clinical expertise, scientific literature analysis, claims data analytics to effectively focus medical polical policy… more
