- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- Job Description Claims Resolution Specialist At Sunshine Enterprise USA, we're not just a company; we're a community of dedicated professionals committed to ... its employees, explore our current job opportunities below. Job Title: Claims Resolution Specialist Department(s): Customer Service Reports to: Supervisor… more
- UHS (Reno, NV)
- …in claims or customer service, 3-5 years' experience with Medicare Advantage, HMO, PPO, and self-funded products preferred Excellent verbal and written ... 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage, Accountable Care Organizations, and commercial payer… more
- Ensemble Health Partners, Inc. (Romney, WV)
- …at Valley - Hampshire Hospital in Romney, WV The Senior Patient Access Specialist is responsible for performing admitting duties for all patients receiving services ... Health Partners and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies and processes that are being performed… more
- Elderwood Senior Care (Buffalo, NY)
- …Shift: Days - 8:00am - 4:00pm #Talroo Responsibilities Electronic billing of Medicare , Medicaid and Third Party Insurance pharmacy claims utilizing Framework ... system. Skilled nursing facility, assisted living facility and private pay pharmacy claim billing Troubleshoot rejected insurance claims resulting in payments… more
- Ensemble Health Partners, Inc. (Bethel Park, PA)
- …PA area. The Opportunity: We are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients ... and distributes patient education documents, such as Important Message from Medicare , Important Message from Tricare, Observation Forms, MOON form, Consent forms,… more
- Florida Orthopaedic Institute (Orlando, FL)
- Position Summary: The Billing Specialist at Orlando Hand Surgery Associates (OHSA) plays a vital role in the financial operations of the practice by ensuring ... billing of patient services. This position is responsible for charge entry, claim submission, payment posting, and follow-up on outstanding accounts. The ideal… more
- DaVita, Inc. (Denver, CO)
- …and multiple internal systems to ensure timely and accurate resolution of Medicare claims Uses exceptional organization, written, and verbal communication skills ... follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims ; Actions include but are not limited to remit and EOB review,… more
- AdaptHealth LLC (Des Moines, IA)
- …click to apply, we would love to hear from you. Customer Service Specialist Customer Service Specialists are responsible for learning and understanding the entire ... Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents… more
- AdaptHealth LLC (Birmingham, AL)
- …lives, please click to apply, we would love to hear from you. Intake Specialist The Intake Specialist has a broad range of responsibilities including accurate ... sources, and appropriately utilizing technology to notate patient information/communication. Intake Specialist 's schedules can vary based on the need of the branch.… more
- Polaris Pharmacy Services (Fort Lauderdale, FL)
- …FL Position Type Full Time Job Category Admin - Clerical Description BILLING SPECIALIST WHO WE ARE Polaris Pharmacy Services is an industry leader in both ... career advancement to all our team members. POSITION OVERVIEW The Billing Specialist ensures accurate billing for Nursing Homes, Assisted Living Facilities, Group… more
- Hackensack Meridian Health (Hackensack, NJ)
- …serve as a leader of positive change. The Physician Practice Compliance Specialist is responsible for assuring on-going compliance by actively participating in the ... services provided throughout the physician enterprise. This position reviews claims , assesses adequacy and recommends enhancements to policies, procedures and… more
- The LaSalle Group (Evanston, IL)
- Job Title: RN Clinical Appeals Specialist Department: Revenue Cycle - Denial Management Location: Onsite-Evanston, IL Schedule: Monday - Friday | 7:00 AM - 4:00 PM ... resolving complex clinical denials through evidence-based appeals. The Clinical Appeals Specialist will play a critical role in identifying denial trends, crafting… more
- Intermountain Healthcare (Cedar City, UT)
- …in and extensive knowledge in the health insurance industry (Commercial Insurances, Medicare , and Medicaid); health claims billing or Third Party contracts. ... EMR experience Bi-lingual - Spanish speaking Knowledge of medical terminology Versed in CPT/ICD codes Physical Requirements: Physical Requirements Interact with others requiring the employee to listen and understand verbal communication and be able to… more
- Healing Partners (Sparks Glencoe, MD)
- Description Insurance Verification Specialist Summary/Overview The Insurance Verification Specialist is responsible for verifying patient demographics and ... billing. Reporting directly to the Revenue Cycle Manager, the Insurance Verification Specialist will assist with revenue and billing operations within their scope.… more
- University of Southern California (Los Angeles, CA)
- …and technical specialist on research projects that use administrative healthcare claims data. SAS is required. The programmer is an integral part of the ... on research projects. Experience with health data, including large administrative healthcare claims data from Medicare or private health insurance plans.… more
- Children's Wisconsin (Milwaukee, WI)
- …on teams assembled to respond to government and commercial audits of claims ; facilitates submission of records and resolution as needed and maintains documentation. ... (Certificate in Healthcare Compliance, Certified Professional Coder, Certified Coding Specialist , Certified Internal Auditor, or equivalent). Understanding of hospital… more
- Duke Health (Durham, NC)
- …other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas. Occ Summary The ... data from multiple sources such as patient medical records, claims , and program metric reports to target recipient(s) and...state of NC, Current licensure as a Licensed Addiction Specialist by the state of North Carolina. Requires ACM… more
- Select Medical (Camp Hill, PA)
- …are exhausted. + Once patient determined to be Medicare Exhaust, specialist files Medicare part A and part B claims to Medicare . + Specialist ... Opportunity Employer/including Disabled/Veterans Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/330016/ medicare -exhaust- specialist -%28healthcare- claims %29/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this… more
- TEKsystems (Chesapeake, VA)
- …System . Knowledge of working FISS(Florida Institutional Shared System) in order to resolve Medicare claim issues . Keep abreast of Medicare / Medicare ... Medicare Patient Account Specialist You'll enjoy... Medicare Patient Account Specialist You'll enjoy Full Time Day Shift Hours...the area A day in the role . Submit Medicare / Medicare Advantage plan claims both… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... of clinic or IPA and/or managed care experience, preferred + Knowledge of Medicare Advantage billing/ claims submission and other related actions, preferred +… more
