- Creative Financial Staffing (Kalamazoo, MI)
- …to supervise all phases of accurate billing of primary, secondary, and tertiary claims to Medicare , Medicaid, Commercial, Work Comp, Automotive, and all others, ... within insurance timely filing limits. Includes billing initial claims , corrected claims , and canceled claims...and timespans in KARE. Coordinates with the Client Access Specialist Supervisor to ensure front end client access … more
- Insight Global (Atlanta, GA)
- …and referrals from other departments. Reviews, corrects and follows up on all Medicare claims via the Florida Shared System maintaining an acceptable status. ... Prepares standardized, uniform, or customized claim forms to all Medicaid/ Medicare and CMO carriers in a timely and accurate...as well as completing referrals, late charges and returned claims from coding and audit accurately and within the… more
- BrightSpring Health Services (Taunton, MA)
- …billing to eliminate financial risks + Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party ... and top-quality care come join our team and apply today! Responsibilities TheClaims Specialist - 3rd Party: + Manages and identifies a portfolio of rejected pharmacy… more
- Montrose Memorial Hospital (Montrose, CO)
- …+ The Claims Analyst III must know the essential functions of denied claims for Medicare , Medicaid and Commercial payers for accurate payments of services ... portals. All About You : + High school diploma or equivalent; Associate degree preferred. + AAHAM(American Association of Hospital Administrative Management) CRCS… more
- Elderwood (Buffalo, NY)
- …The Pharmacy Billing Specialist is responsible for electronic billing of Medicare , Medicaid and Third Party Insurance claims , utilizing Frameworks LTC ... Pharmacy Billing Specialist Responsibilities: + Electronic billing of Medicare , Medicaid and Third Party Insurance claims utilizing Framework… 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 Angeles, ... that purpose. Job Summary The Coordination of Benefits (COB) Validation Specialist ensures the accurate coordination of healthcare benefits for individuals covered… more
- Northern Light Health (South Portland, ME)
- …in customer accounts and billing. + Knowledge of requirements of the Centers for Medicare & Medicaid Services (CMS) claims forms; CMS-1500 and CMS-1450 (UB04). + ... Week: 40.00 Work Schedule: 8:00 AM to 4:30 PM Summary: The Billing Specialist is responsible for coordination of and participation in the billing and reimbursement… 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: 10945 ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… 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, ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and… more
- Trinity Health (Chelsea, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …providers for the past 13 years in a row. **The AR Specialist ** will provide continual and accurate documentation regarding eligibility, authorization, and other ... denials for accuracy as well as sending out initial claims , corrected claims and appeals. This position...departments to ensure appropriate billing system resolutions. + Review Medicare and other primary payments to ascertain which accounts… more
- Emanate Health (Covina, CA)
- …oversight of HCC Program and STAR measures coding related functions. The HCC coding specialist will work with the IPA Director, Health Plan, and MSO personnel on HCC ... or improves upon 4.0 STAR rating. The HCC coding specialist is responsible for education to external physician offices...ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. HCC Coding… more
- Universal Health Services (Reno, NV)
- …of Universal Health Services (UHS). We offer HMO, PPO, and Medicare Advantage plans, Administrative Services for self-funded organizations, and Accountable Care ... the direction of the Manager of Operations, the Appeals Specialist is responsible for ensuring the appropriate review, research,...and appropriate resolution in accordance with the Centers for Medicare and Medicaid Services (CMS) and the state of… more
- Trinity Health (Howell, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Trinity Health (Ann Arbor, MI)
- …Day Shift **Description:** An Opportunity to Join our Remarkable Care Patient Access Specialist awaits YOU!! Trinity Health System is one of the nation's top ... for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and… 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 Time ... to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically necessary referrals… more
- Sevita (Raleigh, NC)
- …a company that positively impacts the lives of others? In the AR Collections Specialist role, you will contribute to the company's commitment to serve others by ... sending claims to the payer in a timely and accurate...needed Qualifications: + High school diploma or equivalent required; Associate or Bachelor's degree preferred + 2-3 years of… more
- Cedars-Sinai (CA)
- …identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS). + Identify through focused audits operational and ... skills to keep references in order. **Qualifications** **Requirements:** + An Associate or Bachelor's degree in Health Information Management or completion of… more
- Glens Falls Hospital (Glens Falls, NY)
- …Come join our team of medical billing experts as the Accounts Receivable Specialist ! This is an exciting opportunity that can further develop your skills in ... customer service, medical billing, and financeinhealthcare. If you are an associate level or an experienced administrative professional with a working knowledge… more
- Robert Half Accountemps (Youngstown, OH)
- …submit claims for DME services to insurance companies, Medicaid, Medicare , and other payers. Verification: Verify patient insurance coverage and eligibility for ... complete and accurate. Follow-Up: Monitor and follow up on outstanding claims , denials, and unpaid invoices. Communication: Communicate with healthcare providers,… more
