- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …Shift Daytime Job Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity ... closely with business and operational units to ensure timely resolution of open issues. The Specialist assumes...and accountability for the timely and accurate identification and resolution of claims issues through thorough research… more
- Monster (Findlay, OH)
- … of edits; trend, identify opportunities, and collaborate with RI Educator and/or Claims Resolution Specialist to avoid/reduce future edits.Support Condition ... support optimal and accurate charge processes; collaborate with CDI Specialist , Claims Resolution Specialist...obtained with 9 months of hire date Knowledge of medical terminology and anatomy and physiology required. Knowledge of… more
- Monster (Crystal, MN)
- …Certifications Specialist is responsible for assuring compliance of third-party claims and certifications. This Certifications Specialist position is a ... Job Title: Quality Certifications Specialist Location: Golden Valley, MN Hours/Schedule: Type: Contract Overview The… more
- Monster (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity ... review. Provides billing with information needed to obtain payment of claims .Remote within local geography after orientation. JOB DUTIES AND RESPONSIBILITIES:… more
- PharmaCord (Lexington, KY)
- …communicating clearly, focusing on the accuracy of the details of their medical records, your mastery of the program requirements, and ensuring their prescriptions ... / denial appeals, and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology,… more
- Monster (New Paltz, NY)
- …experience required (preferably in healthcare) A minimum of 3 years of medical billing experience required Proficiency in EPIC claims processing workflows ... and that processing of denials are at optimal levels Ensure daily/weekly/monthly medical claim submission. Resolve claim and remittance file issues as needed. Ensure… more
- Select Medical (Camp Hill, PA)
- **Overview** **Senior Claims Resolution Specialist ** **Starting at $18.50.00/hr but flexible for experienced candidates** Do you enjoy puzzles and research? ... Are you results-oriented? If so, our Claims Resolution Specialist position may...or Equivalent + One year of experience within a medical billing, medical collecting or claims… more
- Aston Carter (Naperville, IL)
- …+ Arrange with appropriate network and non-network providers to complete claims that cannot be automatically dispatched. + Process provider inquiries and ... assist with special handling claims and service follow-up. + Handle both inbound and...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- Sedgwick (Orlando, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist , Sr. Medical Malpractice (Professional Liability) **PRIMARY ... PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury … more
- Sedgwick (Indianapolis, IN)
- … Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... regulatory and ethics requirements + Accurately and timely assess the indemnity, medical and expense exposure of assigned Specialized claims and manage… more
- Robert Half Accountemps (St. Louis, MO)
- …to discuss this exciting opportunity with you. Requirements * Proven experience in medical insurance claims processing. * Strong knowledge of insurance claim ... Finance & Accounting Contract Talent is currently seeking a highly skilled Healthcare Claims Processor to join our client's team. Opportunity Overview: We are in… more
- Alight (TX)
- …. **About the Role** This role provides leadership and guidance to a team of Claims Specialist who work to resolve billing inquiries & discrepancies . Oversee ... to meet production & quality targets. Enhance operational routines, improve claims resolution methods. Support product delivery while meeting business… more
- NJ Transit (Newark, NJ)
- Claims Specialist (TC) Finance Job Description: Move forward with us! At NJ TRANSIT, you'll join us in transforming the third-largest transportation agency in ... all facets of trial preparation to affect a successful resolution of litigated cases. + Utilizes knowledge, experience and...TRANSIT's assets. + Analyzes, audits and approves payment of medical bills and expenses associated with claims … more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims ,… more
- FlexStaff (Chappaqua, NY)
- **Req Number** 167353 Claims Management Specialist Are you a seasoned medical insurance professional with a passion for leadership and operational ... excellence? FlexStaff is seeking a dynamic Claims Management Specialist for our client to...Qualifications: - Minimum of 3-5 years of experience in medical insurance billing and claims management, with… more
- AssistRx (Phoenix, AZ)
- …internal program team members. + Subject Matter Expert on reviewing and processing of medical claims submitted for copay programs where the therapy is primarily ... The Copay Support/ Claims Processing Specialist is a critical...Required engagement is with pharmacy claim adjudicators, third party medical claim administrators, merchant vendors, finance for manual claim… more
- Cognizant (Malvern, PA)
- …of claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support...HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered… more
- Ascension Health (Austin, TX)
- …and resolving health-care claim payment appeals and communicating resolution /determination in accordance with the standards and requirements established ... by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. +… more
- NJ Transit (Newark, NJ)
- Senior Claims Documentation Specialist Risk Management & Claims Job Description: Move forward with us! At NJ TRANSIT, you'll join us in transforming the ... public and foster good will by tactful handling and resolution of problems related to the position. + Must...of the organization and functions of the Risk Management/ Claims Department. At NJ Transit you will enjoy a… more
