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Claims Issue Resolution Coordinator Ii Jobs

Claims Resolution Coordinator Jobs
By GAIUS Networks (Flipped.ai) At United States
Answercustomer service lines as necessary and responds toprovider inquiries either byphone, email,or in person regardingclaims-related questions.
Reviews, researches, and workswith various departments to resolve complex providerinquiries, appeals, and grievances.
ProcessesCIFs and adjustments as needed.
Writesand runsreports in Business Objects to obtain needed claim data.
Tracksand analyzesprovider trends with denials and CIFsto provide support toproviderswith an opportunity to improve.Distributesprovider scorecards.
Trackscomplaints, appeals, and grievances by the program. Reportsactivities on a quarterlybasis to IQI, PHC Compliance Coordinator,and Claims Director.
Issue Resolution & Quality Coordinator
By DeKalb County, GA At , Decatur, Ga $58,662 - $94,446 a year

Salary Range: $58,662-$94,446 FLSA: Exempt The purpose of this classification is to monitor and coordinate quality assurance and resolution of complex customer service issues for the ...

Issue Management Analyst Jobs
By Cash App At Atlanta, GA, United States
Contribute tactical and strategic initiatives to improve oversight and issue management, processes, tools, and reporting capabilities
5+ years of experience in Issue, Risk, or Control Management
Heading efforts related to issue management activities
Contribute to the implementation and continuous development of any systems and/or tools used to support Issue Management activities
Excellent communication, influencing, and interpersonal skills
Exceptional analytical skills, with ability to formulate recommendations for solutions based on business, risk, and control objectives
Medicare Claims Resolution Specialist - Remote -Digitech
By Sarnova At United States
Handle all correspondence via mail, email and any necessary refunds; perform other duties as assigned by management
Strong computer skills. Basic understanding of MS Outlook, Word and Excel.
Experience in an environment where calls were monitored and scored as well as metrics applied to individual performance is helpful.
Excellent communication skills, both written and verbal. Able to present information and solutions in a professional and courteous manner.
Shift M-F 830am-5pm EST. Fully Remote. Work from the comfort of your home.
Review claims that have been put on hold, working to identify causes and address issues causing them to remain on hold
Claims Specialist Ii Jobs
By Everest Re Group, Ltd. At , Township Of Warren, 07059, Nj $90,000 - $135,000 a year
Management and direction of outside counsel as well as reviewing and approving legal and/or expense budgets and bills
Determine and resolve workload and assignment issues to ensure effective claims processing, expense management and claims disposition
Vendor oversight and management, including auditing of same
The ideal candidate will have 5+ years of Commercial Property claims experience and current, working knowledge of jurisdictional laws and regulations.
Ability to and willingness to present to senior management and other group settings
Execution: Delivering outstanding support to the organization through strong day-to-day business operations, effective project management, and careful oversight of vendors.
Claims Resolution Specialist Jobs
By Impresiv Health At Orange, CA, United States

The Claims Resolution Specialist provides assistance in resolving provider claims payment status issues, provider payment disputes, eligibility, and authorization verification. The incumbent will be ...

Manager- Issue Management - Remote
By Nordstrom At United States
Leverage communication and influencing skills to guide issue resolution, root cause, and remediation plans throughout the issue management process.
Process and Project Management skills preferred
Manage and drive the Issue Management process from Start to Finish in alignment with policies and procedures
Partners with Compliance, Legal, and Risk Management to determine control gaps
Strong analytical acumen with proficiency in Excel, Project Management Tools, and other MS Office suite products.
Experiencing working in business, risk management, or other relevant control function is a plus
Claims Resolution Spec, Apd
By Liberty Mutual Insurance At United States
Reports coverage denials to manager.
General knowledge of contract language, including regulatory and policy differences, legal liability and general insurance policy coverage
Excellent oral, written and interpersonal communication skills, and the capacity to multi-task in a structured work environment, are required
Associates degree or equivalent training plus generally two or more year's auto non-injury claims handling experience
Requires frequent coverage research and analysis resulting in final coverage decision.
Negotiates coverage and liability decisions with insured, claimant, claimant carrier.
Issue Resolution Analyst Jobs
By Visionaire Partners At Atlanta Metropolitan Area, United States
2 years of professional work experience resolving large ticket volume issues
Experience executing a project from start to end
Intermediate Excel skills - ability to do VLOOKUPS, Pivot tables, formulas
Excellent communication and customer service skills
Reviewing internal, web-based system to resolve issues that have been recorded in the system for resolution
Working as a liaison between the field and cross functional partners to meet resolution
Issue Analyst Jobs
By Cash App At Atlanta, GA, United States
Contribute tactical and strategic initiatives to improve oversight and issue management, processes, tools, and reporting capabilities
5+ years of experience in Issue, Risk, or Control Management
Heading efforts related to issue management activities
Contribute to the implementation and continuous development of any systems and/or tools used to support Issue Management activities
Excellent communication, influencing, and interpersonal skills
Exceptional analytical skills, with ability to formulate recommendations for solutions based on business, risk, and control objectives
Issue Management Lead Jobs
By Cash App At , St. Louis, Mo
5+ years of experience in Issue, Risk, or Control Management
Meaningful knowledge across the enterprise risk management and/or operational risk management frameworks, including risk identification, risk strategy, processes and controls
Track record of managing internal relationships and demonstrated experience in leading sustained change and change management efforts
In collaboration with the Operational Risk and Operational Excellence Leadership, design, development and implementation of the CCO issue management program
Facilitation of the Issue Management program across CCO
Training of stakeholders on issue management and onboarding to the program
Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At Bethany, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At Piedmont, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution
By PeopleScout At Moore, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At McLoud, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At Moore, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Claims Resolution Specialist Jobs
By Ascension At , Nashville, 37201, Tn From $20.80 an hour
Strong Knowledge of healthcare claims, Medicaid, Medicare, Pharmacy benefits, etc.
Schedule: Full-Time, 8am - 5pm, Mon-Fri, fully remote
Facility: Automated Benefit Services (ABS)
Complex Medical Claims experience, preferred
5 years of healthcare experience, preferred
Review and respond to escalated internal and external calls and emails from participants, providers and provider reps.
Complex Rehab Billing & Claims Resolution Specialist
By ACU-Serve At , Akron, 44308, Oh
Performs other related duties as assigned by management
Ability to work with all levels of management.
Strong organizational, problem-solving, and analytical skills; able to manage priorities and workflow.
Dependability – Follows instructions, responds to management direction, completes tasks on time or notifies appropriate person of alternative plan.
Knowledge of Complex Rehabilitative Equipment including but not limited to coding, modifiers, narrative information, parts, repairs, and loaner equipment.
Ability to analyze and/or gain knowledge to interpret Commercial, Medicaid, Medicare, and Medicare Advantage Plan Local Coverage Determinations and Policy Guidelines.
Reporter, Sunday Issue (Tues-Sat)
By New York Post At New York, NY, United States
Strong news gathering skills and experience with social media platforms in order to quickly confirm information during live news events
5+ years of relevant experience covering news on the local or national level
Experience working in a fast paced news environment
Quickly writing clear, concise copy on national and local news
Delivering long and short form journalism in the boldest tabloid voice
Spotting a potentially viral story and quickly turn it into a great read
Executive Resolution And Payment Claims Analyst
By Early Warning Services At , Scottsdale, 85260, Az
Supports the company’s commitment to risk management and protecting the integrity and confidentiality of systems and data.
Own the consumer experience for all Early Warning Products, including Zelle and FCRA
Calling the consumer immediately to listen to their experience and recommend a solution to the problem
Proven record of payments fraud analysis experience in a consumer facing team environment
Excellent interpersonal and communication skills.
Understand the importance of decision making and the impact to regulatory requirement

Are you looking for an exciting opportunity to use your problem-solving skills to help customers? We are looking for an experienced Claims Issue Resolution Coordinator II to join our team. In this role, you will be responsible for resolving customer claims issues in a timely and efficient manner. You will have the opportunity to work with a variety of stakeholders to ensure customer satisfaction. If you are a motivated individual with excellent communication and customer service skills, then this is the job for you!

Overview:

Claims Issue Resolution Coordinator II is responsible for resolving customer complaints and inquiries related to insurance claims. They are responsible for researching and resolving customer issues, ensuring customer satisfaction, and providing timely and accurate responses to customer inquiries.

Detailed Job Description:

Claims Issue Resolution Coordinator II is responsible for researching and resolving customer complaints and inquiries related to insurance claims. They must be able to effectively communicate with customers, insurance companies, and other stakeholders to ensure customer satisfaction. They must be able to accurately document customer interactions and provide timely and accurate responses to customer inquiries. They must be able to identify and resolve customer issues in a timely manner.

What is Claims Issue Resolution Coordinator Ii Job Skills Required?

• Excellent customer service skills
• Excellent communication skills, both verbal and written
• Ability to multitask and prioritize tasks
• Ability to research and analyze customer issues
• Ability to work independently and as part of a team
• Knowledge of insurance claims processes and procedures
• Knowledge of customer service principles and practices
• Knowledge of applicable laws and regulations

What is Claims Issue Resolution Coordinator Ii Job Qualifications?

• Bachelor’s degree in a related field or equivalent experience
• At least two years of experience in customer service or a related field
• Knowledge of insurance claims processes and procedures
• Knowledge of customer service principles and practices
• Knowledge of applicable laws and regulations

What is Claims Issue Resolution Coordinator Ii Job Knowledge?

• Knowledge of insurance claims processes and procedures
• Knowledge of customer service principles and practices
• Knowledge of applicable laws and regulations

What is Claims Issue Resolution Coordinator Ii Job Experience?

• At least two years of experience in customer service or a related field

What is Claims Issue Resolution Coordinator Ii Job Responsibilities?

• Respond to customer inquiries and complaints related to insurance claims
• Research and resolve customer issues in a timely manner
• Document customer interactions and provide timely and accurate responses to customer inquiries
• Identify and resolve customer issues in a timely manner
• Communicate with customers, insurance companies, and other stakeholders to ensure customer satisfaction
• Maintain customer records and update customer information as needed