- 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 ... and related health plan functions such as member services, claims , and the referral process. As well as functions...+ Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) + Prioritizes… more
- Methodist Health System (Dallas, TX)
- …resolve no response claims , denied claims , and correspondence. As an AR II Specialist , you will play a crucial role in optimizing revenue flow by ... Job** : We are seeking an experienced Accounts Receivable II (AR II ) Specialist specializing...follow up for family and specialty claims , able to identify, address, and… more
- Nebraska Public Power District (Columbus, NE)
- …when employee restrictions exist. Incumbent will assist FMLA/ADA & Worker's Compensation Specialist II with ongoing program development needs, the Employee ... **FMLA/ADA & Worker's Compensation Specialist I or II ** Columbus, NE,...ensures timely processing of the District's Self-Insured Workers' Compensation claims . The incumbent processes leave requests and accommodations, particularly… more
- Elevance Health (AL)
- …and prevent unnecessary medical-expense spending. **Title** : Financial Operations Recovery Specialist II **Location:** This role enables associates to work ... granted as required by law. The **Financial Operations Recovery Specialist II ** is responsible for the discovery,...responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the… more
- MyFlorida (Largo, FL)
- ELIGIBILITY SPECIALIST II - 60065685 Date: Sep 11, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 860801 Agency: Children and Families Working Title: ELIGIBILITY SPECIALIST II - 60065685 Pay Plan: Career...+ Customer Service with goals of problem solving and resolution + Conducting Face to Face interviews. KNOWLEDGE, SKILLS… 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: ... to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training...additional service needs according to specific program guidelines. Uses claims processing and care management software to look up… 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, ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- MyFlorida (Fort Myers, FL)
- ELIGIBILITY SPECIALIST II - 60040415 Date: Sep 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 860103 Agency: Children and Families Working Title: ELIGIBILITY SPECIALIST II - 60040415 Pay Plan: Career...+ Customer Service with goals of problem solving and resolution . KNOWLEDGE, SKILLS AND ABILITIES: + Knowledge of public… more
- Hartford HealthCare (Farmington, CT)
- …HealthCare will always be the first. The Accounts Receivable & Denial Specialist II assures timely and accurate submission of claims on UB04 or HCFA1500 ... hospitals, medical group and homecare. Accounts Receivable & Denial Specialist II is responsible for the following...claim is denied; . Takes appropriate action for payment resolution ; documents all activity in accordance with standard work… more
- Beth Israel Lahey Health (Burlington, MA)
- …helps to resolve callers' issues, retrieving critical information that impacts the resolution of current or potential future claims . 3. Establishes relationships ... Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and...Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 1-2 years of… more
- AIG (Atlanta, GA)
- Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our ... service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes… 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
- Cedars-Sinai (Los Angeles, CA)
- …in other revenue cycle functions and provide back-up coverage. The Revenue Cycle Specialist II : + Participates in department meetings and provides feedback to ... that fuels innovation. **Req ID** : 11453 **Working Title** : Revenue Cycle Specialist II (Commercial Collections) **Department** : CSRC HB Follow Up **Business… more
- Grifols Shared Services North America, Inc (Research Triangle Park, NC)
- …field. Engineering degree preferred, Medical technologist certificate preferred. **Experience:** Specialist level II : **3 years'** experience with ... in more than 110 countries and regions. **Summary:** The **Tier 1 Technical Support Specialist (TSS) for Medical Devices in the field of IVD** at the Grifols DxCTS… more
- AIG (Atlanta, GA)
- …investigate, evaluate and resolve Commercial General Liability and Auto Liability claims . Provides exceptional customer service and commitment to bring assigned ... cases to a timely, proper resolution . This requires accurate and thorough documentation, as well...upon the applicable law, coverage and supporting evidence. Assigned claims typically consists of medium to moderate complex litigated… more
- Boardwalk Pipeline Partners (Houston, TX)
- …found online at www.bwpipelines.com . We are currently looking for a Sourcing Specialist I/ II /III/Sr for our Houston, TX office. POSITION DESCRIPTION: + Procure ... procedures to expedite or coordinate deliveries. + Facilitate the resolution of disputes and claims . + Address...+ Facilitate the resolution of disputes and claims . + Address all Sarbanes-Oxley documentation requirements for qualifying… more
- Dickinson Financial Corporation (Kansas City, MO)
- **Summary** The Dispute Resolution Specialist II is responsible for processing EFT investigation claims in a fast-paced work environment. This role will ... inquiries and research for both internal and external clients. Successful Dispute Resolution Specialist II must be capable of following limited, conceptual… more
- University of Utah Health (Salt Lake City, UT)
- …and overall patient outcomes. **Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + Performs contract compliance on ... This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts… more
- Cedars-Sinai (Los Angeles, CA)
- …our care the most. **Req ID** : HRC1268782 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business Entity** : ... performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating… more
- Baylor Scott & White Health (Dallas, TX)
- …level **Job Summary** + Under the Safe Choice Claims Manager, the Safe Choice Claims Specialist II reviews, studies, and processes assigned claims ... efficient service while protecting the organization's assets. + The Claims Specialist II 's main duty...improvements in processes to increase proficiency and supervise effective resolution of all claim inquiries. + Responsible for the… more
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