- BrightSpring Health Services (Uniondale, NY)
- …and top-quality care come join our team and apply today! Responsibilities TheClaims Specialist - 3rd Party: + Manages and identifies a portfolio of rejected pharmacy ... claims to ensure maximum payer reimbursement and timely billing...D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to… more
- Elevance Health (Louisville, KY)
- **Recovery Specialist Associate ** **Location** : Louisville, KY - Waukesha, WI - Indianapolis, IN **Hours:** 7:30 am - 4:00 pm CST / 08:30 am - 5:00 pm EST ... **may** require you to come into the office **periodically** ** The **Recovery Specialist Associate ** is responsible for identifying and initiating third-party /… more
- Elderwood (Buffalo, NY)
- …Pharmacy Billing Specialist is responsible for electronic billing of Medicare, Medicaid and Third Party Insurance claims , utilizing Frameworks LTC Pharmacy ... Pharmacy Billing Specialist Responsibilities: + Electronic billing of Medicare, Medicaid and Third Party Insurance claims utilizing Framework LTC Pharmacy… more
- Conduent (Los Angeles, CA)
- … Specialist ** **Pay $18-20hr 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
- Northern Light Health (South Portland, ME)
- …accounts and billing. + Knowledge of requirements of the Centers for Medicare & Medicaid Services (CMS) claims forms; CMS-1500 and CMS-1450 (UB04). + Knowledge ... 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
- 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
- Sevita (Raleigh, NC)
- …a company that positively impacts the lives of others? In the AR Collections Specialist role, you will contribute to the company's commitment to serve others by ... sending claims to the payer in a timely and accurate...needed Qualifications: + High school diploma or equivalent required; Associate or Bachelor's degree preferred + 2-3 years 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
- 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
- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** SHP Pharmacy Benefits Specialist (Remote) **Cost Center:** 682891381 SHP-Pharmacy **Scheduled Weekly Hours:** 40 ... **Job Description:** **JOB SUMMARY** The Security Health Plan (SHP) Pharmacy Benefit Specialist is responsible for the daily administration of the SHP pharmacy… more
- Commonwealth of Pennsylvania (PA)
- HIPP Operations Specialist Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4525992) Apply HIPP Operations Specialist Salary $49,839.00 - ... exciting prospects that await you! DESCRIPTION OF WORK As a HIPP Operations Specialist , you will review and evaluate employer group health insurance for eligibility;… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve medically necessary referrals… more
- Glens Falls Hospital (Glens Falls, NY)
- …Come join our team of medical billing experts as the Accounts Receivable Specialist ! This is an exciting opportunity that can further develop your skills in ... customer service, medical billing, and financeinhealthcare. If you are an associate level or an experienced administrative professional with a working knowledge… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically necessary referrals… more
- Hartford HealthCare (Farmington, CT)
- …of third party revenue cycle activities associated with outstanding insurance claims across all Hartford HealthCare hospitals, medical group and homecare to ... insure optimal revenue cycle performance. The AR Follow Up & Denials Specialist is responsible for resolving unpaid third party balances on $550 million in active… more
- Highmark Health (Columbus, OH)
- …medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and support of Risk Adjustment Data ... Risk Adjustment Data Validation (RADV) audit coding review, including analysis of claims data to ensure chart acquisition is complete and documentation is… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **37378BR** **Extended Job Title:** Coding Specialist (Medical Coding/Alberta) **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Review ... is needed for accurate code assignment + Review claim denials. Resubmit corrected claims by required filing deadlines. + Perform charge data entry for billing in… more
- University of Utah Health (Salt Lake City, UT)
- …trust that are integral to our mission. EO/AA_ The Provider Enrollment Specialist is responsible for obtaining and coordinating all necessary provider enrollment ... applications for billing to Medicare, Medicaid and Contracted Insurance Payers. Functionally, these activities are...working enrollment issues. + Responsible for working provider enrollment claims in Epic. + Follows department and Insurance payer… more
- Queen's Health System (Honolulu, HI)
- …plans and other third party payor requirements, as assigned. * Ensures accurate claims submission to optimize revenue for the Medical Center, as assigned. * Responds ... AND LICENSURE: * High school diploma or equivalent education. * Associate 's or Bachelor's degree in business administration, finance, accounting or healthcare… more
- Commonwealth Care Alliance (Boston, MA)
- …Assurance, the incumbent is responsible for independent quality reviews of medical claims , and evaluating Call Center activities for compliance with policies and ... to the business area leadership. For Medical Claim reviews, post-payment review of claims that were manually processed by a Claim Examiner to assess financial and… more