- CVS Health (Monroeville, PA)
- …of insurance billing or collections, accounts receivable experience, health plan claims processing or adjudication experience, or other acceptable ... + 3+ Years of insurance billing or collections, accounts receivable experience, health plan claims adjudication experience, or other acceptable… more
- Mass Markets (Killeen, TX)
- …1-3 years of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer… more
- CVS Health (Richardson, TX)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...frameworks that drive the state-of-the-art Pharmacy Services - Claim Processing Application. You will work on integrating cloud-native solutions,… more
- CVS Health (Franklin, TN)
- …or staffing shortages. **Required Qualifications** * 3+ years of experience in health insurance claims processing , preferably with Medicare Supplement ... and every day. **Position Summary** The Team Lead for the Medicare Supplement Claims Processing team is responsible for overseeing day-to-day operations to… more
- UCLA Health (Los Angeles, CA)
- …you will play a critical role in in ensuring the timely, accurate, and compliant processing of health insurance claims . The ideal candidate will be ... will: + Coordinate and monitor the daily workflow of claims processing . + Distribute unprocessed claims... plan) - Required + Comprehensive knowledge of industry-standard claims adjudication policies, including CCI edits, COB… more
- Elevance Health (Miami, FL)
- …and experience possible. The ** Claims Representative III** is responsible for keying, processing and/or adjusting health claims in accordance with ... 50,000 members, HealthSun is one of the fastest growing health plans in South Florida. As a local plan,...interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims . + Adjusts voids and… more
- Martin's Point Health Care (Portland, ME)
- …maintain claims payment accuracy. Job Description Key Outcomes: + Drives quality, timely claims processing to allow the health plan to achieve regulatory ... operational readiness for system fixes, configuration, and project rollouts impacting claims processing + Ensures operational readiness, testing, training,… more
- CHS (Clearwater, FL)
- …insurance companies, employers, and members. In this pivotal role, you'll oversee claims adjudication , drive operational strategy, and ensure high accuracy and ... clients. * Management of relationships with essential vendors involved with the Claims Adjudication process, including clearinghouses, claims cost control… more
- CenterLight Health System (NY)
- …+ Validate Diagnosis-Related Group (DRG) grouping and (re)pricing outcomes presented by the claims processing vendor to ensure accuracy. + Attend Joint Operating ... + Proficiency in data analytics, ie SAS, SQL. + Claims adjudication and understanding of claims...in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database software.… more
- CommonSpirit Health (Erlanger, KY)
- …to return, pend, deny or pay claims ). + Follows and ensures claims processing is consistent with applicable policies, regulations, procedures and department ... processing enhancements. + Responsible for managing the STD claims team but is not limited to the following:...Provide technical expertise and direction to team members on claims adjudication for STD. + Facilitate the… more
- State of Minnesota (St. Paul, MN)
- …minimum qualifications will be considered for this position.** Two (2) years* experience processing claims and/or appeals with one (1) of those years involving ... Claims Adjudicator involves lead work and handles escalated claims , ensuring accurate adjudication and compliance with...Training and mentoring of other staff to enhance their claims processing abilities. + Knowledge of techniques… more
- Independent Health (Buffalo, NY)
- …certificate and/or college degree preferred. + Six (6) months of medical claims processing /medical billing experience, customer service experience preferably in ... relates to production, accuracy, knowledge of policy and procedure and timeliness of claims adjudication . + Analyze, identify and research, as needed, edits… more
- Dignity Health (Bakersfield, CA)
- …role responsible for the detailed and accurate processing , review, and adjudication of complex healthcare claims . This position requires expert knowledge of ... claims processing , coding, and regulatory compliance. The Claims ...Certified Professional Coder (CPC) **Overview** The purpose of Dignity Health Management Services Organization (Dignity Health MSO)… more
- Sedgwick (Glendale, CA)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and… more
- FlexStaff (Bronx, NY)
- …Subrogation conditions - Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor - Attends JOC meetings with providers as ... creating and testing compensation grids used for reimbursement and claims processing - Ensures that refund checks...within a healthcare or managed care setting (preferred) - Claims adjudication experience - Knowledge of MLTC/… more
- Sedgwick (Ontario, CA)
- …team meetings and assigns accountability for follow-up items. + Gathers important compliance/ claims processing information to be presented at team meetings. + ... compensation claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices… more
- Sedgwick (Topeka, KS)
- …growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Long Beach, CA)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Molina Healthcare (Cedar Rapids, IA)
- …or GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 1-3 years' experience in claims adjudication , Claims Examiner II, or other relevant work ... payments using tools such as DSHS and Medicare billing guidelines, Molina claims ' processing policies and procedures, and other such resources to validate… more
- Sedgwick (El Dorado Hills, CA)
- …compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices. **ESSENTIAL ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Associate - Workers Compensation - El Dorado Hills, CA **PRIMARY PURPOSE** :… more
Related Job Searches:
Adjudication,
Claims,
Claims Processing,
Health,
Health Claims,
Health Claims Processing,
Processing