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Confidential
A company is looking for a Medical Claims Intake Coordinator for a temporary remote position. Responsibilities: Intake and create cases in all applicable systems Perform timely data entry of necessary information Perform adjustments on medical...
Confidential
A company is looking for a Medical Claims Intake Coordinator. Key Responsibilities: Intake and create cases in all applicable systems Perform timely data entry of necessary information Perform adjustments on medical claims and outreach to...
Confidential
A company is looking for a Cdr, Complaint Appeals. Key Responsibilities: Manage resolution of Fast Track Appeals for Medicare products Research and analyze Fast Track appeals for all products and services Coordinate all components of Fast...
Confidential
A company is looking for a Medical Claims Investigator. Key Responsibilities: Achieve measured production, quality, and growth results Utilize analytics and data mining techniques to analyze and audit medical claims Evaluate medical claims for...
Confidential
A company is looking for a Clinical Appeals Analyst. Responsibilities: Exercise clinical knowledge to make determinations about medical needs or alternatives Assess, process, and complete non-routine appeals and grievance to ensure customer...
Confidential
A company is looking for an Insurance Claims Specialist - Medical. Key Responsibilities: Manage and resolve rejected pharmacy claims to ensure maximum payer reimbursement and timely billing Research and analyze rejected claims, working with...
Confidential
A company is looking for a Medical Insurance Claims Specialist. Key Responsibilities: Manage and resolve rejected pharmacy claims to ensure maximum reimbursement Contact providers and customers for additional claim information Monitor and...
Confidential
A company is looking for a Carrier Claims Coordinator. Key Responsibilities: File client claims for all carriers within 24 hours of notification Manage and resolve client claims for all carriers Develop professional relationships with client...
Confidential
A company is looking for an Appeals and Grievances Medical Director - Plastic Surgeon. Key Responsibilities: Perform individual case review for appeals and grievances related to medical services Communicate with medical directors and network...
Confidential
A company is looking for a Medical Biller with Anesthesia experience for a full-time night shift position. Key Responsibilities: Post medical charges, payments, and journal entries to patient accounts accurately and in a timely manner Work with...
Confidential
A company is looking for a Claims Services Analyst to review managed care contracts and compare them against healthcare claims to identify underpayments for clients. Responsibilities: Thoroughly review managed care contracts and compare them...
Confidential
A health plan is looking for a Claims Examiner to process hospital and medical claims, resolve claims of moderate complexity, as well as research, resolve and respond to inquiries. Key Responsibilities: Process hospital and medical claims...
Confidential
A company is looking for a Claims Director responsible for coordinating all operational management activities related to the Claims unit. Key Responsibilities: Coordinate claims processing, provider claims services, research, and projects...
Confidential
A company is looking for a Claims Analyst for their Value Based Care - Client Operations team. Key Responsibilities: Process, review, audit, and investigate high-level coding discrepancies in claims Manage HCFA and UB92 Workflow Queues in the...
Confidential
A health plan is looking for a Claims Specialist. Responsibilities: Execute the process of adjudicating claims with accuracy and completeness as defined in the claims manual Process assigned claims for payment or denial in accordance with...
Confidential
A company is looking for a Claims Examiner. Key Responsibilities: Adjudicate healthcare claims based on specific policies and procedures Review claims processing system data and compare it with corresponding UB04 or CMS1500 Review adjudication...
Confidential
A company is looking for a Sr Claim Benefit Specialist. Key Responsibilities: Review and adjudicate complex, sensitive, and specialized claims in accordance with plan processing guidelines Act as a subject matter expert by providing training,...
Confidential
A company is looking for a Repricing Coordinator. Key Responsibilities: Reprice medical and dental claims using multiple applications to obtain discounted rates Key repriced claims into the QicLink system Communicate effectively with team...
Confidential
A company is looking for a Remote Intake Specialist - Bilingual. Key Responsibilities: Talks directly with patients and their families to determine their needs and medical history Schedules various appointment types for multiple locations...
Confidential
A company is looking for a Medicaid Claims Resolution Specialist. Key Responsibilities: Work on pending, denied, or incorrectly paid Medicaid claims Review and address issues causing claims to remain on hold Handle denials and appeals,...
Confidential
A company is looking for a Senior Medical Writer. Responsibilities: Create documents for all phases of drug development Coordinate journal/abstract submissions Provide professional guidance to authoring teams Qualifications: PhD, MD, MPH,...
Confidential
A company is looking for an Auto Claims Specialist. Key Responsibilities: Review and research accident claims, contacting patients, insurance representatives, and attorneys to verify details and obtain maximum payments Submit bills to...
Confidential
A company is looking for a Claims Examiner II. Key Responsibilities: Adjudicate healthcare claims based on employer and payer-specific policies and procedures Review claims processing system data and compare it with corresponding UB04 or...
Confidential
A company is looking for a Casualty Claim Consultant for a remote position. Key Responsibilities: Establishing and following up on action plans and diaries Engaging claim adjusters in discussions of strategy, action planning, and...
Confidential
An organization is seeking an Assistant Claims Analyst for a remote contract role in Pawtucket, RI. Responsibilities: Support Claims Analyst in retrieving back-up documentation for deductions and creating PDF Adobe documents Complete various...
Confidential
A company is looking for a Senior Medical Coder for a remote position. Key Responsibilities: Evaluate medical records for accurate coding of procedures, diagnoses, and billing Identify trends in documentation issues and coding practices to...
Confidential
A company is looking for a Medical Customer Service Representative. Key Responsibilities: Verify and correct customer demographic information Research and resolve customer inquiries to ensure satisfaction Educate providers and serve as a...
Confidential
A company is looking for a Manager, Claims (MPL Programs). Key Responsibilities: Analyze and verify insurance coverage for claims Assign losses to claim staff and evaluate liability, damages, and causation Manage staff, develop claims...
Confidential
A company is looking for a Medical Policy and Pricing Advisor. Responsibilities: Conduct medical utilization audits to ensure quality control Provide recommendations on health care policy and procedure development Assist in developing pricing...
Confidential
A company is looking for a Medical Customer Service Representative. Key Responsibilities: Verify and correct customer demographic information through phone communication Research and resolve customer inquiries to ensure customer satisfaction...
