- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr....the request based on business needs and requirements, provider resolution option based on financial ability and forecasting for… more
- Guthrie (Sayre, PA)
- …payers. Reports possible payer or submission issues. 2. Works closely with a Denial Resolution Specialist or Billing Specialist II mentor to cross train ... payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy,...in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to… 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
- Mount Sinai Health System (New York, NY)
- …and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. ... **Job Description** The Procedural Billing Specialist I is responsible for multiple components of...Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and… more
- Henry Ford Health System (Jackson, MI)
- …obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new practices, and conducting audits ... Network. * Serves as the point of contact for Network practices to address claims issues with Network payors by troubleshooting on behalf of the practice and working… more
- Cedars-Sinai (Torrance, CA)
- …collections support, performing duties which may include reviewing and submitting claims to third party payors, performing account follow-up activities, updating ... accounts. Independently initiates dialogue with payor and/or patient to ensure resolution of accounts (eg, responds to additional documentation requests, refers… more
- Cedars-Sinai (Torrance, CA)
- …collections support, performing duties which may include reviewing and submitting claims to third party payors, performing account follow-up activities, updating ... experience to include hospital billing and/or collections experience required. + CPC preferred. **Skills/Experience we are Seeking:** Proven ability to handle… more
- Southeast Health (Dothan, AL)
- …Summary Performs daily activities involved in the reimbursement process, ie claims filing/follow-up, entry of payments/adjustments, and follow-up on non-payment or ... payer portals, work traditional Medicare and Medicare Advantage/Replacement inventory to full resolution . Job Description Essential Functions + Works as part of a… more
- University of Virginia (Charlottesville, VA)
- …edits and follow-up work queues, identifies areas of opportunity based on findings/ resolution of errors. + Manages assigned charge review and coding-related claim ... for Business Services and physician office requests regarding non-billed or non-reimbursed claims . + Completes special projects as directed by coding leadership. +… more
- University of Rochester (Rochester, NY)
- …include, but are not limited to, coding abstraction, pre-bill coding edits, claims resolution functions, and providing recommendations to enhance coding acuity, ... by effectively managing the assigned functional area and serving as the team's coding specialist . This role acts as a subject matter expert on team functions and… more
- Insight Global (Pawtucket, RI)
- …and Requirements -Medical Billing or Pro Fee billing Experience -Familiarity with claims processing or CPC certification -Onsite Requirement: Must work hybrid ... Job Description As a Billing Specialist , you will manage the end-to-end medical billing...patient and insurance information, coding procedures accurately, and submitting claims . You will follow up on unpaid or denied… more
- Henry Ford Health System (Troy, MI)
- …fraud, compliance, and any other issue. Aside from committee meetings, assist with claims resolution issues as needed. + Assist in requesting and tracking ... to achieve desired results. CERTIFICATIONS/LICENSURES REQUIRED: + Certified Professional Coder ( CPC ) required but Certified Coding Specialist (CCS) and/or… more
- Ellis Medicine (Schenectady, NY)
- …Requirements: High School Diploma or Equivalent required. Certified Professional Coder ( CPC ), Certified Coding Specialist (CCS), Registered Health Information ... and related work lists to ensure complete, timely and accurate submission of claims , (3) facilitating the accuracy and completeness of the practice's codes and… more
- University of Rochester (Albany, NY)
- …Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred + Certified Professional Coder ( CPC ) from ... for system edit reviews and follows up on insurance coding denials for resolution . **ESSENTIAL FUNCTIONS** + Uses knowledge of coding systems and system logic to… more
- University of Rochester (Rochester, NY)
- …Coding Specialist (CCS). Preferred + Or Certified Professional Coder ( CPC ) from American Academy of Professional Coders (AAPC) or Certified Medical Coder ... guidelines. + Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides feedback for correction… more
- University of Rochester (Albany, NY)
- …Coding Specialist (CCS) preferred or + Certified Professional Coder ( CPC ) from American Academy of Professional Coders (AAPC) or Certified Medical Coder ... guidelines. + Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides feedback for correction… more