- Guidehouse (Gardena, CA)
- …Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative - Medicare Emphasis** is an ... (Manager, Talent Acquisition) at ###_** **Essential Job Functions** + Medicare Claims + Account Review + Appeals... + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service… more
- State of Indiana (Indianapolis, IN)
- Medicare Claims Analyst Date Posted: May 8, 2024 Requisition ID: 443202 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with the ... accessible, and equitable workplace with a workforce that is representative of Indiana's population. As a proud equal opportunity...is fully engaged with this mission. Role Overview: The Medicare Claims Analyst will serve as the… more
- HCA Healthcare (Denver, CO)
- …purpose and integrity. We care like family! Jump-start your career as a Medical Insurance Claims Representative today with HCA Healthcare. **_*This position ... by location._** Come join our team as a Medical Insurance Claims Representative . We care...and administer contracts in collection of third party accounts ( Medicare and Medicaid) + You will complete account reconciliation… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** Humana/iCare is seeking a Claims Research and Resolution Representative 2 to join our growing team. This ... projects, complicated and unusual claims . The Claims Research and Resolution Representative 2 will...to make an impact** **Required Qualifications:** + 1-3 years claims experience in an HMO or health insurance… more
- Sedgwick (King Of Prussia, PA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Liability **PRIMARY PURPOSE** : To process low ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Sedgwick (King Of Prussia, PA)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative **PRIMARY PURPOSE:** To analyze mid- and higher-level ... general liability claims to determine benefits due; to ensure ongoing adjudication...**Skills & Knowledge** + Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets… more
- BrightSpring Health Services (Arlington, TX)
- …in obtaining information completing necessary documentation or following up on outstanding claims + Individual with an understanding of Insurance and Medicaid ... Competitive pay Shift differential Health, dental, vision and life insurance benefits Company paid STD and LTD Tuition Assistance...as assigned + Achieves productivity goals with regard to calls/ claims per hour as determined by the Director and… more
- Trinity Health (Farmington Hills, MI)
- …the banking industry or a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, ... performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities or an equivalent combination of education… more
- Highmark Health (Charleston, WV)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- Insight Global (Los Angeles, CA)
- …Insurance Plan based in Los Angeles is in the immediate need of a Medical Claims Representative . The Medical Claims Representative will be responsible ... phone and troubleshooting any of the participants bills or claims . The Medical Claims Representative ...CPT codes. - Extensive knowledge of Plan benefits, group insurance , and Medicare principals. - Knowledge of… more
- Randstad US (El Dorado Hills, CA)
- …Skills + Communication + Workers Compensation Reporting Claims + Disability Insurance + Social Security + Medicare Compliance + Microsoft Office (4 ... who has a minimum of 4 years of California Workers' Compensation Claims Representative experience and is looking for a 3-month plus work-from-home consulting… more
- Centers Plan for Healthy Living (Farmingdale, NY)
- …Experience Required: 3+ years of claim processing experience, preferably in a Medicaid/ Medicare , MLTC environment, Customer Service in health insurance product ... Claims Examiner 465 Smith St, Farmingdale, NY 11735,...PHYSICAL REQUIREMENTS : The physical requirements described here are representative of those that must be met by an… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …of Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product ... Claims Auditor 75 Vanderbilt Ave, Staten Island, NY...PHYSICAL REQUIREMENTS : The physical requirements described here are representative of those that must be met by an… more
- Travelers Insurance Company (Irvine, CA)
- …**What Is the Opportunity?** Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
- Travelers Insurance Company (Lake Oswego, OR)
- …**Target Openings** 1 **What Is the Opportunity?** Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
- New York State Civil Service (Albany, NY)
- …Managed Care, Medicare claims , prescription drug programs such as Medicare Part D, Elderly Pharmaceutical Insurance Coverage (EPIC), Low Income Subsidy, ... Medicare Savings Program, and other health insurance programs. The incumbent will assist with developing and managing contracts with entities responsible for… more
- Spurwink Services (Portland, ME)
- …on denials and outstanding accounts receivable for the agency. Including outstanding Medicare and third-party insurance and miscellaneous billing accounts older ... Representative will also follow up, correct and resubmit claims for all government and non-government denials in a...to Maine Care. + Follow up on all outstanding Medicare , Third Party Insurance , and Miscellaneous Billing… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …or health plan insurance environment. Knowledge of health Care and insurance and the ability to Interpret/Apply Medicare Prescription Drug Benefits, Medical ... to administrative issues related to health plan operations including claims resolution, premium billing, medical benefit interpretation, organization and coverage… more
- Travelers Insurance Company (Diamond Bar, CA)
- …under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and ... Claim team is committed to partnering with our business insurance customers to help their injured employees return to...you will handle all aspects of a workers compensation claims . In this role, you will learn how to… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Plan Build Representative 2 selects, implements, and loads the system applications that administer plan ... provisions. Florida or Georgia Plan Build Representative 2 + Conducts daily review of claim pending...a healthcare setting + 1 or more years of Claims , Provider relations and/or Provider Services experience + Working… more
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