- University of Rochester (Rochester, NY)
- …the payer. + Research and calculate under or overpaid claims ; determine final resolution + Re-calculate claim based on fee schedule, APC or APG grouper, ... the process conforms to federal and state regulations. The Claim Resolution Rep III will represent the...status on appropriate payer system or contact an insurance representative to obtain information as to why claims… more
- Travelers Insurance Company (Overland Park, KS)
- …deep technical expertise to assist in the resolution of highly complex claims . Mentor other Claim Professionals + Participate in Telephonic and/or onsite ... collaboration with specialty resources (ie medical and legal) to proactively pursue claim resolution opportunities, (ie return to work, structured settlement,… more
- Travelers Insurance Company (St. Paul, MN)
- …existing offsets, including apportionment, contribution and subrogation. + Facilitate timely claim resolution by leveraging any mitigation opportunities. + ... with specialty resources (ie medical and legal) to proactively pursue claim resolution opportunities, (ie, structured settlement, discontinuation of benefits… more
- Travelers Insurance Company (Federal Way, WA)
- …structured settlement/annuity as appropriate for the jurisdiction. + Facilitate timely claim resolution by leveraging any mitigation opportunities. INFLUENCE AND ... claims . Attempt to resolve through innovative and expert claim management. This work may include: Remains out of...diagnoses, Medicare Set Aside or injury severity to achieve resolution through the best possible outcome. + Co-manage appropriate… more
- Travelers Insurance Company (Hartford, CT)
- …medical providers, and legal counsel. + Investigate, develop, and evaluate action plans for claim resolution . Assess coverage and determine if a claim is ... for quality claim handling including investigating, evaluating, negotiating, and resolving claims on losses of lesser value and complexity and provide claim … more
- Metropolitan Council (St. Paul, MN)
- …to the Workers' Compensation claim . Negotiate any disputed bills for resolution . + Adjust claims with the ability to follow company/departmental policies ... Workers' Compensation Claims Representative II - REPOST Print...position is eligible for a hybrid (both remote and onsite ) telework arrangement. Candidate's permanent residence must be in… more
- Community Health Network (Indianapolis, IN)
- Patient Account Resolution Representative Job Ref 2405343 Category Administrative & General Support Job Family Customer Service Department Revenue Cycle-Customer ... Hours WFH 9:00 am to 5:30 pm M-F Mandatory onsite meetings Possible return to onsite if...it without you. **Make a Difference** The Patient Account Representative is responsible for managing all aspects of accounts… more
- Martin's Point Health Care (Portland, ME)
- …bonus * Paid Parental Leave * Pet Insurance * Employee Assistance Program * Onsite gym in Portland, annual gym reimbursement for other locations * Annual bonus based ... not fully remote position. Job Description The Member Service Representative will interact and support our Health Plan members...for support when needed, as well as coordinates the resolution of inquiries with other departments at Martin's Point.… more
- Guidehouse (Mitchell, SD)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Patient Account ... Representative (PAR) is expected to perform specific billing processes,...is expected to perform specific billing processes, follow-up, account resolution , adjustments and scanning as required. This position works… more
- ManpowerGroup (Bellevue, WA)
- …RESPONSIBILITIES:** + **Warranty Claim Processing** + Facilitate construction warranty claims by scheduling, evaluating and ensuring proper resolution to ... team!** Learn more . **JOB SUMMARY:** The Customer Service Warranty Representative is responsible for scheduling subcontractors, evaluating the subcontractor's work… more
- Elevance Health (Indianapolis, IN)
- …from CS Units, Provider Inquiry Units, members, providers and/or others for resolution or affirmation of previously processed claims . + Ensures appropriate ... **Title: Grievance/Appeals Representative I** **Location:** This position will work a... I** is responsible for reviewing, analyzing and processing claims in accordance with policies and claims … more
- Elevance Health (KS)
- …guide external LTSS providers through customer service including training, contracting assistance, claims resolution and advocacy. **How you will make an ... **LTSS Network Education Representative Sr** **Location** : This position will work...limited to:** + Provides/coordinates provider training for programs, services, claims and billing procedures, contract compliance and special health… more
- University of Rochester (Rochester, NY)
- …the payer. + Research and calculate underpaid or overpaid claims ; determine final resolution . + Re-calculate claim based on fee schedule, APC or APG grouper, ... status on appropriate payer systems or contact an insurance representative to obtain information as to why claims...for claim denial or reason for unpaid claim . Address unpaid claims , and solicit a… more
- Fairview Health Services (St. Paul, MN)
- …Fairview Health Services has an opportunity for a Patient Financial Services Representative ! The CSC Representative will counsel patients on financial solutions ... to 4:30 pm. **This position requires 4 weeks of onsite training at our Corporate Campus in Saint Paul,...bills, clarification of detail on bill, etc. Analyze paid claims for accuracy of payments and or rejections and… more
- US Tech Solutions (Columbia, SC)
- **Job Title: Call Center Representative ** **Location: 4101 Percival Road, Columbia, SC 29229** **Duration: 3+ Months (Contract to Hire)** **Job Description:** + ... Onsite role, ONLY + Schedule : Mon-Fri, 8AM-4:30PM +...they will be a part of team presentations?) -conflict resolution , time management, positive attitude, teamwork, and adaptability +… more
- Trinity Health (Ann Arbor, MI)
- …Type:** Full time **Shift:** Rotating Shift **Description:** This position is 100% onsite which will require the selected individuals to report to our physical ... the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Schedules,… more
- Conduent (Guaynabo, PR)
- …where individuality is noticed and valued every day. **Bilingual Fraud Customer Service Representative ** **100% - Onsite Guaynabo, PR** $12.10 HR Opportunity to ... Benefits and Paid Training!** **Summary:** As a **Bilingual Fraud Customer Service Representative ,** you will be responsible for the resolution of multi-product… more
- ManpowerGroup (Austin, TX)
- Bilingual onsite Call Center Positions in Austin, TX (Spanish). Two plus years of Call Center experience needed. Must be available for any 8-hour shift from 7 am to ... 30 miles from Austin, TX and able to work onsite each day at customer location. Must be bilingual...assistance to Medicaid clients with questions regarding eligibility, medical claims status, and other program questions in English and… more
- Crawford & Company (Pocatello, ID)
- …of property. Responsibilities + Uses knowledge of property and construction to conduct onsite inspections of property damage and photograph claim sites to depict ... for moderately complex to highly complex residential and commercial property claims by conducting thorough field investigations to evaluate damages and determine… more
- Elevance Health (Olathe, KS)
- …and medical policy, reimbursement and provider utilization patterns. + Coordinates prompt claims resolution through direct contact with providers, claims , ... **Network Relations Consultant, LTSS Provider Representative ** **Location:** Kansas. This position will work a...existing providers as needed. + Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues,… more