- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Supervisor , Claims Review makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Supervisor , Claims Review works within thorough, prescribed guidelines and… more
- Sedgwick (Raleigh, NC)
- …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and… more
- Carrington (Raleigh, NC)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred losses ... this position is $23.00/hr - $26.50/hr. **What you'll do:** Review reconciliation of all loan advances once the GSE...manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, but… more
- Ryder System (Raleigh, NC)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Cardinal Health (Raleigh, NC)
- …Collections is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... receivable and increase cash flow for the organization. **_Responsibilities:_** + Review aging reports and work insurance accounts to ensure timely resolution… more
- Walgreens (Raleigh, NC)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , or District Manager. Operations + Counsels patients and answers questions ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist is responsible for ensuring that elements of… more
- Cummins Inc. (Kenly, NC)
- …required documentation, such as work completed documents, time sheets, warranty claims , quality documents via handwritten forms or business system input screens. ... and legislation and reports any issues / incidents to their supervisor . **Diesel Technician Level III** **Key Responsibilities:** Applies documented procedures and… more
- Cardinal Health (Raleigh, NC)
- …to patient inquiries in a professional and timely manner. **_Responsibilities:_** + Review aging reports and work patient accounts to ensure timely resolution and ... billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs)… more
- Cardinal Health (Raleigh, NC)
- …payment + Work average of 50 to 100 denials per day based on supervisor requirements and accounts assigned + Works closely with insurance carriers for reimbursement ... + Consults with appeals department for disputed / denied claims . + Works / Understands electronic claim interchange +...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Walgreens (Raleigh, NC)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist has the ultimate responsibility for ensuring that… more
- JE Dunn Construction Company (Raleigh, NC)
- …JE Dunn. + Autonomy & Decision-Making: Makes most decisions and consults with supervisor as needed. + Career Path: Planning & Scheduling Manager **Key Role ... effective and efficient best practices for scheduling are utilized. Diplomatically communicates review comments to the project team. + Participates in all phases of… more
- CVS Health (Raleigh, NC)
- …distribution of the monthly premium invoices. The Billing Premium Consultant must review invoices for reasonability and accuracy and make any necessary adjustments ... billing systems. + Execute monthly invoices on appropriate billing platform and review group specifications to ensure all appropriate information is included with… more
- Walgreens (Raleigh, NC)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. **Communication** + Communicates with pharmacy… more
- Army National Guard Units (Raleigh, NC)
- …Retention Processing 2 (MRP2), and Medical Boards to include MOS Medical Review Board (MMRB), Medical Evaluation Board (MEB), and Physical Evaluation Board (PEB); ... RESOURCES SPECIALIST, GS-0201-12, you will serve as a personnel supervisor and advise in one or more of the...provide transcripts or other documentation to support your Educational claims . To receive credit for Education, you must provide… more