- USAA (Tampa, FL)
- …guidelines. + Applies advanced medical expertise by serving as primary resource for Health Claims for the approach to medical risk assessment rules. + ... Reviews and interprets relevant medical literature for application to health claims policies and guidelines. + Collaborates with senior leaders and staff to… more
- Mount Sinai Health System (New York, NY)
- …**Qualifications** + HS/GED; Associates Degree is preferred + **1-2 years of experience in medical billing or health claims , with experience in billing ... accounts via online work file and/or hard-copy reports; checks claims status, re-submits claims , and writes appeal...Health System is one of the largest academic medical systems in the New York metro area, with… more
- TEKsystems (Pasadena, CA)
- … Processing,Member Claims , Health information management Additional Skills & Qualifications Health / Medical Claims experience - PPO claims ... Description -Accurate and timely processing of medical claims -Investigation/communication in order to...claims system Skills PPO Insurance, Claims , Claims Processing, Member Claims , Health … more
- CHS (Clearwater, FL)
- **Overview** ** Health Insurance Medical Claims Examiner** **(Initial Training On Site - 90 days - Remote position after training in FL)** **Must live within ... **Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and established guidelines.… more
- Mount Sinai Health System (New York, NY)
- …CPC Preferred + Training in computerized medical billing + 3 years experience in medical billing or health claims , with experience in IDX billing systems ... these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution....Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- …diploma/GED plus 3 years of relevant experience + Certified coder required + Experience in medical billing or health claims , with experience in EPIC & IDX ... these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution....Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (Wantagh, NY)
- …coding + Certified Professional Coder preferred **Experience requirements:** + 2 years experience in medical billing or health claims , with experience in IDX ... System:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across… more
- University of Utah Health (Salt Lake City, UT)
- …**Qualifications** **Required** + Three years of experience collecting, organizing and maintaining health insurance and processing medical claims . + ... **Overview** _As a patient-focused organization, University of Utah Health exists to enhance the health ...determine if adjustment is necessary. + Adjusts and documents medical claims or electronic records. + Researches… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... planning audits and audit work programs that address appropriate claims and financial compliance criteria for specialty health...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Elevance Health (Miami, FL)
- …The ** Claims Representative III** is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. ... **Job Title:** Claims Representative III **Schedule:** Monday-Friday 7am-3:30pm EST **Virtual**...50,000 members, HealthSun is one of the fastest growing health plans in South Florida. As a local plan,… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Manager, Medical Malpractice and General Liability Claims is responsible for overseeing professional and general liability claims , ... efforts as appropriate. This role provides leadership to outside claims adjusters, ensuring compliance with organizational policies and insurance reporting… more
- Providence (TX)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... + Work with defense attorneys specializing in defense of medical negligence claims + Have direct responsibility...including a retirement 401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life… more
- Atrius Health (Chelmsford, MA)
- …benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** * Medical Claims Follow-Up Representative* **Location:** ... more than 690,000 adult and pediatric patients at 30 medical practice locations in eastern Massachusetts. Atrius Health...responsible for the follow up and resolution of denied medical billing claims for assigned payer(s). In… more
- LA Care Health Plan (Los Angeles, CA)
- …tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with LA Care. This role works ... auditing procedures under minimal supervision during the audits of medical groups and health plans. Provide timely...audit results. Perform claims audits for all medical groups and health plans contracted with… more
- AIG (Lenexa, KS)
- …skills and experience as a valued member of the team. Make your mark in Accident and Health Claims Our Claims teams are the proven problem solvers of choice ... to external and internal customers. + Handle Accident & Health claims as part of the A&H...and total disability, critical illness and/or accident and sickness, medical evacuation, trip cancellation, out of country medical… more
- Elevance Health (Mason, OH)
- **Title: Claims Representative I ( Health & Dental) - FEP** **Mason, OH** **Location:** This role enables associates to work virtually full-time, with the ... Friday druring training; 9 AM - 5:30 PM EST after training.** The ** Claims Representative I** will be responsible for successfully completing the required basic… more
- Elevance Health (Latham, NY)
- **Title: Claims Representative I ( Health & Dental) - FEP** **Latham, NY** **Location:** This role enables associates to work virtually full-time, with the ... AM - 4:30 PM EST, Monday - Friday.** The ** Claims Representative I** will be responsible for successfully completing...Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- Humana (Columbus, OH)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … more
- Humana (Annapolis, MD)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … more
- Humana (Salem, OR)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … more
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