- UnisLink (Phoenix, AZ)
- …codes (CPT, HCPCS, ICD-10) and healthcare claim forms. Knowledge of electronic health records (EHR) and claims processing software. Familiarity with different ... with long-term career potential? UnisLink is hiring a Medical Claims Clerk to support our billing and operations teams....as the primary resource for printing and mailing secondary claims and appeals for multiple clients. Handling unprinted … more
- BeOne Medicines (San Mateo, CA)
- …evidence (RWE) generation using large-scale healthcare data sources (eg, electronic health records, claims , registries). This role will collaborate with ... for observational and RWE studies derived from diverse real-world data sources, including claims , electronic health records (EHRs) and registry data. + Conduct… more
- Lyric (Newtown Square, PA)
- …+ 1+ years of combined experience in healthcare, such as prior work in health insurance, claims processing or adjudication, or fraud, waste and abuse detection ... medical insurance claim overpayments through recovery (40%) + Review claims for missing or incomplete information, calculate payment, or...payments as a Payment Integrity Vendor or within a Health Plan's Payment Integrity team. + 1+ years of… more
- Commonwealth Care Alliance (Boston, MA)
- …platforms, provider portals, or data visualization tools. + Working knowledge of health plan claims and payment policies, including provider reimbursement ... The program manager is responsible for managing and implementing key population health and network quality initiatives to achieve high performance on CCA's… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …activities. This role involves auditing, assessing, and analyzing data to ensure that health plan claims , and capitation reimbursement revenue are received in ... will be responsible for loading, reconciling, and reporting monthly health plan pay and chase revenue, as well as...that may affect revenue + Prepare and file stop-loss claims with reinsurance carriers for high-cost or catastrophic cases… more
- Jobleads-US (Saddle Brook, NJ)
- …Experienced Education: Bachelors Degree Job Family: Insurance and Claims Compensation: Salaried Exempt Position Description: Oversee insurance carriers ... (TPAs) in their management and handling of affiliated clients' Workers' Compensation claims in an assigned geographic region of the country based upon program… more
- Jobleads-US (Houston, TX)
- …to Grow" with us? Pay range: $130,000.00 YOUR ROLE: The Workers Compensation Claims Manager is responsible for the oversight and positive performance of CEVA's Third ... (TPA) as they adjust, manage and administer our workers' compensation claims portfolio insured through traditional Workers Compensation insurance lines, monopolistic… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …maintaining member files + Claims experience and or knowledge of claims processes + Experience in a Health Insurance environment **Diversity Statement** ... **Overview** BroadPath is seeking an **Electronic Claims Analyst** to join our dynamic, fully remote...you will play a key part in processing electronic claims , researching and resolving claims -related issues, and… more
- Morley (CA)
- …case details? If so, this role could be a perfect fit for you! As a Legal Claims Analyst at Morley, you'll play a key role in managing small automotive claims ... to support the client's defense strategies, including lemon law claims + Serve as the "Person Most Knowledgeable" (PMK)...than your paycheck. It's the combination of competitive pay, health benefits and other benefits Morley provides - your… more
- Stony Brook University (St. James, NY)
- …cycle operations, encompassing systems expertise, patient registration and throughput, health information management, claims processing and reimbursement, payer ... multi-hospital inpatient and outpatient services, physician practice registration, scheduling, health information management, and patient accounting systems. **Duties of… more
- Carrot (Des Moines, IA)
- …for everyone, everywhere. Trusted by more than a thousand multinational employers, health plans, and health systems, Carrot's comprehensive clinical program ... Bachelors Degree 1-3 years of relevant work experience including claims submission/processing experience Highly detail-oriented and organized Structured thinker and… 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, ... details of information and comments, as well as actions taken. Review claims by approving or disapproving customers claims . Review insurance invoices… 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
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all ... This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized… more
- Ally (Trenton, NJ)
- …dreams, and causes that are all important to them. Our focus is on the health and safety of our teammates as well as work-life balance and diversity and inclusion. ... that can appraise and/or adjust physical damage and mechanical claims within an assigned territory and key point or...reimbursement, and other financial well-being programs. * Supporting your Health & Well-being: flexible health and insurance… more
- Lyric (Newtown Square, PA)
- …development, renewal discussions, and client growth initiatives. + Provide expertise on health plan payment policies, claims editing methodologies, and their ... primary and secondary code edit frameworks. + Deep expertise in health plan payment policies and claims editing, with a strong understanding of their impact on… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Medical Directors and other Premera Departments such as FEP, National Account Liaisons, Health Care Services and Claims to ensure appropriate cost-effective care ... team, and disease management). + Collaborates, educates, and consults with Customer Service/ Claims Operations, Sales and Marketing and Health Care Services to… more
- ReturnPro (Miami, FL)
- …inventory feedback to help shape future lot creation. Monitor order health including buyer claims , credit percentage, and post-sale issues-collaborating ... cross-functionally to improve buyer satisfaction and reduce friction. Ensure 100% payment collection within five business days of order creation, following up with buyers as needed. Qualifications Bachelor's degree in Business, Marketing, Sales, or a related… more
- Insmed Incorporated (NJ)
- …studies and clinical trial endpoint selection, disease natural history, medical claims and electronic health records, database analyses, economic models, ... You Are:Advanced degree in an HEOR or related field ( health services research, public health , epidemiology, ...or related field ( health services research, public health , epidemiology, health economics, psychometrics); PhD strongly… more
- Lyra Health Inc (Irvine, CA)
- About Lyra Health Lyra Health is the leading provider of mental health solutions for employers supporting more than 20 million people globally. The company ... has delivered 13 million sessions of mental health care, published more than 20 peer-reviewed studies, and...results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental… more
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