A company is looking for a Specialist I, RCM - Claims Submission. ...
Team Lead - Medicare Specialist. ...
A company is looking for an Assoc Claims Specialist. ...
The Senior Claims Specialist will report directly to the Director of Risk Management. Ensure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management. Review and approve the status of a...
Key Responsibilities:Support the implementation of a comprehensive risk identification frameworkConduct compliance deep dive claim reviews and oversee the Adjuster Licensing programSupport the Legislative Change Process and conduct ad hoc research into laws and regulationsRequired Qualifications:5+ ...
Revenue Integrity Analyst / Claims Review Specialist. Analyze hospital billing claims within the EHR and claim scrubber system. Resolve claim errors, edits, and other holds. Understanding of Medicare/Medi-Cal claims processing guidelines. ...
Workers’ Compensation Claims Specialist. You’ll maintain phone and written contact with all necessary parties to verify coverage and to investigate, manage and resolve medical-only claims promptly and accurately. This is an excellent career opportunity as a Claims professional. Conducting meetings o...
As a Field Claims Specialist, you’ll investigate, evaluate and resolve material/physical damage of a moderate to severe nature. You’ll be responsible for handling claims according to prescribed authorization and claims best practices. Maintains current knowledge of insurance and applicable product/s...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
The Prudential Claims Specialist role is essential in handling retirement claims and processing financial transactions on behalf of clients. The team’s focus areas include claims processing for short-term disability, long-term disability, retirement, and death claims. This position requires high mul...
Processes all types of medical claims and adjusts medical disputed claims (Professional and Facility) according to department, contract, and regulatory requirements. Responsible for processing, auditing, and adjusting all facility medical claims, appeals and prepayment audits. Troubleshoots claims t...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work closely with other members of the Commercial Services Operations team providing root ...
Working under minimal supervision, the Member Experience Specialist – Claims contributes to Wawanesa’s goal of delivering an exceptional and consistent claims service experience by enhancing relationships with members through tracking and trending feedback utilizing various data sources. Works colla...
PMCL IN22 Grow Your Skills, Grow Your Potential Responsibilities This position is for a Property Field Inspection Claim Specialist, handling accidental and weather-related homeowners, commercial, and large loss claims. You will be the first point of contact to meet with our insureds, explain coverag...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
As an Appeals Specialist, you play a critical role in reviewing and resolving member and provider complaints. ...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or *** Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and compa...
The Senior Claims Specialist will report directly to the Director of Risk Management. Ensure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management. Review and approve the status of a...
Team Lead - Medicare Specialist. ...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...