- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …Integrity initiatives and projects. This role will act as the point of contact for claim related research. Serves as a claims subject matter expert (SME) and ... Acts as a claims subject matter expert (SME) and resource/support for claim edit and payment policy initiatives Conducts in-depth research on complex claim … more
- UnisLink (Phoenix, AZ)
- …of a growing team with long-term career potential? UnisLink is hiring a Medical Claims Clerk to support our billing and operations teams. No prior medical billing ... will include: Acting as the primary resource for printing and mailing secondary claims and appeals for multiple clients. Handling unprinted claims and ensuring… more
- Collectors Holdings, Inc. (Santa Ana, CA)
- …Hong Kong, Toronto, Guadalajara, Dallas, and Paris. We're looking for a Claims Investigator to join our Collectors Claimsteam, providing essential assistance to our ... their times of need. Our team's core responsibility revolves around efficiently handling claims for customers who may have encountered damage or loss of their items… more
- Hallmark Financial (Dallas, TX)
- Job Description: Position Title: Senior Claims Adjuster (Fast Track- Bodily Injury) Job Summary: Investigates, evaluates, negotiates and resolves claims of ... and interaction with insured's and claimants in accordance to established claims procedures and state regulations. Essential Duties and Responsibilities include the… more
- WEL Companies (De Pere, WI)
- …1st Shift Job Category Safety Description POSITION SUMMARY As a Claims Representative, you'll be interacting with WEL departments, drivers, insurance companies, ... information and comments, as well as actions taken. Review claims by approving or disapproving customers claims ....Review claims by approving or disapproving customers claims . Review insurance invoices for accuracy. Investigate when damage… more
- Carrot (Des Moines, IA)
- …Bachelors Degree 1-3 years of relevant work experience including claims submission/processing experience Highly detail-oriented and organized Structured thinker and ... issues An innovative spirit to push the boundaries of claims operations Preferred Qualifications: Literacy in Spanish (to support...to lean in to changing priorities and processes Track claims and denials through the entire lifecycle Identify gaps… more
- Bond Legal (Irvine, CA)
- …on the clients' behalf when appropriate *Draft, review, and modify claims , motions, discovery responses, demand letters, pleadings, subpoenas, memorandums, and other ... legal documents *Investigate potential personal injury claims and provide legal advice to prospective clients accordingly *Record and update the status of all case… more
- Hallmark Financial (Dallas, TX)
- …The Compliance Specialist: Accurately processes monthly compliance review ensuring regulatory compliance. Essential Functions include the following. Other duties may ... be assigned. Process monthly and quarterly SOX compliance control testing. Assist with internal and external compliance audits. Maintain compliance records. Complete additional compliance related tasks as they arise Qualifications To perform this job… more
- Independent Living Systems (Miami, FL)
- …within the healthcare industry. Proficient knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid reimbursement methodologies (ie ... PPS, FFS, APG, Capitation, etc.) required. Must possess good understanding of claim adjudication process including ICD, CPT, HCPCS Strong proficiency in business… more
- CHRISTUS Health (Winona, TX)
- …CHRISTUS services. These services will be provided by monitoring cases and claims , analyzing biometric and health risk assessment data, organizing disease management ... cost analysis and other reports to determine the reasonableness of claim /cost data and utilization rates.Make recommendations based on data analysis for… more
- PharmaCord (Jeffersonville, IN)
- …and resources related to local, regional or national payer coverage or claim submission process Clearly articulate complex reimbursement and billing information to ... and regional payer coverage policies, issues, coding changes, and appropriate claims submission processes Educate offices about the medical necessity requirements… more
- Syufy Enterprises (San Rafael, CA)
- …proactive communication and problem-solving. Administer and manage worker's compensation claims company wide, ensuring compliance with legal requirements and timely ... resolution of claims . Work closely with insurance providers and employees to...closely with insurance providers and employees to facilitate smooth claim processing and return-to-work programs. Collaborate with hiring managers… more
- JS Perkins Consulting (Falls Church, VA)
- …improve financial oversight and increase collections through the Medical Affirmative Claims (MAC) and Third-Party Collections (TPC) programs. This role will provide ... and prepare files with all necessary documents necessary to assert a claim against the third-party. Assist in organizing and preparing supporting documentation for… more
- Premier Auto Credit (Glendale, CA)
- …has insurance coverage, the verification specialist will inform the insurance claim specialist. The insurance verification specialist will: Ensure that insurance ... of potential losses by identifying opportunities to open and resolve insurance claims on insured vehicles that are damaged. Ensure that all insurance verification… more
- Aftermath Billing (Port Saint Lucie, FL)
- …Collector is responsible for managing accounts receivable for behavioral health claims , including follow-up with insurance payers and patients. This role plays ... applicable regulations. Key Responsibilities: Monitor and manage outstanding behavioral health claims . Follow up with insurance companies to ensure timely payment.… more
- Whit Blanchard Insurance Group (Augusta, GA)
- …with clients and claims adjusters to process all documentation reporting a claim on a current policy *Answer clients completely on policy or billing questions ... legal regulations. You will help customers understand their coverage, assist them with any claims as needed, and ensure all relevant data is properly tracked in our… more
- Eisai, Inc (Nutley, NJ)
- …well as managing Eisai's insurance requirements to provide optimum coverage, costs, and claim settlements is falls within the scope of this position.The Manager of ... calculations for premium adjustments; Manage the end-to-end process of claim settlement, including documentation, coordination with insurers, and resolution;… more
- Interior, Bureau of Indian Affairs (Portland, OR)
- …MUST provide transcripts or other documentation to support your educational claims . Unless otherwise stated: (1) official or unofficial transcripts are acceptable, ... undergraduate course work (credit hours) were taken on a pass/fail basis, your claim of superior academic achievement must be based upon class standing or membership… more
- BOX PARTNERS LLC (Elgin, IL)
- …damage issues Respond timely to customer service and sales requests File carrier claims and manage claim payments Understand carrier pricing tariffs to enable ... proper audit of daily freight invoices Run monthly carrier aging reports and work with accounting to keep payables current Provide accurate shipping quotes to purchasing, customer service, and sales Build positive relationships with other departments and… more
- Universities of Wisconsin (Madison, WI)
- …safety, and environmental management quality property, liability, and worker's compensation claims management protection of UW System assets risk assessments and ... areas of high risk, providing guidance and expertise on workers compensation claims and workplace injuries, negotiating insurance policies on behalf of the UW… more
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