- Medical Mutual of Ohio (Centerville, OH)
- …. Performs other duties as assigned. **Qualifications** **SDC- Claims /Customer Care Specialist I** **Education and Experience:** . Associate degree in ... Heath Insurance Portability and Accountability Act (HIPAA). **SDC- Claims /Customer Care Specialist II** **Education and Experience:** . Associate degree in… more
- BrightSpring Health Services (Honolulu, HI)
- …billing to eliminate financial risks + Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party ... and top-quality care come join our team and apply today! Responsibilities TheClaims Specialist - 3rd Party: + Manages and identifies a portfolio of rejected pharmacy… more
- Medical Mutual of Ohio (Brooklyn, OH)
- **_The Claims /Customer Care Specialist - TPA position allows you the flexibility to work at home as long as you reside within a 50-mile radius of the Brooklyn, ... in accordance with established performance expectations and service philosophy. **Responsibilities** ** Claims /Customer Care Specialist I - TPA** . Processes… more
- Conduent (Los Angeles, CA)
- … Specialist ** **Pay $17-22hr (Based on Experience)** The Insurance/Collections Specialist is responsible for analyzing medical claims data, seeking ... timely, maximum call time is achieved, and ensures quality results. Insurance-Collections Specialist will handle the collection/recovery of medical claims with… more
- MD Anderson Cancer Center (Houston, TX)
- …of the PBS Billing Specialist position is to bill and follow-up on Medicare claims within regulatory guidelines. The PBS Billing Specialist must ensure ... of modifier logic, HCPCS/CPT codes and revenue line code descriptions. 2. Complete claims in daily billing workqueue 3. Correct Medicare RTP Billing rejections… more
- Elderwood (Buffalo, NY)
- …The Pharmacy Billing Specialist is responsible for electronic billing of Medicare , Medicaid and Third Party Insurance claims , utilizing Frameworks LTC ... Pharmacy Billing Specialist Responsibilities: + Electronic billing of Medicare , Medicaid and Third Party Insurance claims utilizing Framework… more
- Montrose Memorial Hospital (Montrose, CO)
- …healthcare. All About You : + High school diploma or equivalent; Associate degree preferred. + AAHAM (American Association of Hospital Administrative Management) ... CRCS (Certified Revenue Cycle Specialist ) preferred. + 2 years hospital PFS department experience...knowledge of hospital billing, collections and payment application for Medicare , Medicaid and Commercial insurances + Ability to effectively… more
- Elevance Health (Columbus, OH)
- …send you a check, or ask you for payment as part of consideration for employment. **eCOB Specialist II** + Job Family: CLM > Claims Support + Type: Full time + ... WOBURN + MA, NEWTON 55 CHAPEL ST **Description** **eCOB Specialist II** **Location:** Hybrid, within 50 miles of Elevance...correct forms are provided to assist members enrolling in Medicare . + Reviews claim history to identify claims… more
- LA Care Health Plan (Los Angeles, CA)
- Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals Department: Claims Integrity Location: Los Angeles, ... that purpose. Job Summary The Coordination of Benefits (COB) Validation Specialist ensures the accurate coordination of healthcare benefits for individuals covered… more
- Northern Light Health (South Portland, ME)
- …in customer accounts and billing. + Knowledge of requirements of the Centers for Medicare & Medicaid Services (CMS) claims forms; CMS-1500 and CMS-1450 (UB04). + ... Week: 40.00 Work Schedule: 8:00 AM to 4:30 PM Summary: The Billing Specialist is responsible for coordination of and participation in the billing and reimbursement… more
- Aston Carter (West Des Moines, IA)
- … will be responsible for accurately processing billing documentation, handling claims , ensuring compliance with Medicare and Medicaid regulations, and ... tasks. + Process Billing Documentation: Accurately process invoices, statements, and claims for senior living homes' medical services. + Claim Management: Handle… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 10945 ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more
- Adams County Government (Westminster, CO)
- … Specialist is responsible for generating and processing medical claims within the Electronic Health Record (EHR) system, implementing payment arrangements, ... Medical Billing and Coding Specialist -165320 Print (https://www.governmentjobs.com/careers/adams/jobs/newprint/4469087) Apply Medical Billing and Coding … more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and… more
- Trinity Health (Chelsea, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …providers for the past 13 years in a row. **The AR Specialist ** will provide continual and accurate documentation regarding eligibility, authorization, and other ... denials for accuracy as well as sending out initial claims , corrected claims and appeals. This position...departments to ensure appropriate billing system resolutions. + Review Medicare and other primary payments to ascertain which accounts… more
- Emanate Health (Covina, CA)
- …oversight of HCC Program and STAR measures coding related functions. The HCC coding specialist will work with the IPA Director, Health Plan, and MSO personnel on HCC ... or improves upon 4.0 STAR rating. The HCC coding specialist is responsible for education to external physician offices...ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. HCC Coding… more
- Universal Health Services (Reno, NV)
- …of Universal Health Services (UHS). We offer HMO, PPO, and Medicare Advantage plans, Administrative Services for self-funded organizations, and Accountable Care ... the direction of the Manager of Operations, the Appeals Specialist is responsible for ensuring the appropriate review, research,...and appropriate resolution in accordance with the Centers for Medicare and Medicaid Services (CMS) and the state of… more
- Trinity Health (Howell, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Trinity Health (Ann Arbor, MI)
- …Day Shift **Description:** An Opportunity to Join our Remarkable Care Patient Access Specialist awaits YOU!! Trinity Health System is one of the nation's top ... for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and… more