Healthcare - Case Management Processor
By Dice At United States
Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
Healthcare - Case Management Processor, Remote.
Provides support to the Case Management staff performing non clinical activities and supporting the management of the department.
Responsible for initial review and triage of Case Management tasks.
Screens members using Molina policies and processes assisting clinical Case Management staff as they identify appropriate medical services
Runs reports to assist in coordination of case management needs.
Claims Processor (English Speaking)
By Carrot Fertility At United States
1-3 years of relevant work experience including claims submission/processing experience
Excellent verbal and written communication skills
Problem-solving skills to analyze, troubleshoot and resolve issues
Structured thinker and love checking things off your to-do list
An innovative spirit to push the boundaries
Ability to thrive in a fast-paced, results-oriented environment
Claims Processor Ii Jobs
By Premera Blue Cross At United States
Review, process, and resolve moderately complex claims in accordance with contracts and policies.
Research claims through the utilization of reference materials and on-line tools.
Responsible for accurately coding claims through the system.
Translate data into information acceptable to the claims processing system including follow up on pended claims.
Maintain all appropriate claims files and perform follow-up on pended claims.
Prepare claims for return to Provider or Subscriber when additional information is needed.
Healthcare Claims Support Associate
By CareCentrix At United States
Knowledge of basic spreadsheet / word processing / data entry and basic math skills required.
Knowledge of Claims Management and URAC standards preferred.
Tracks claim detail errors and communicates to up-line management for coaching and training purposes.
Must have minimum 1 year work experience.
Two years of customer service, claims processing, medical terminology, medical services or equivalent experience required.
Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
Healthcare Claims Data Analyst ( W-2 Only )
By Apex Systems At United States
In Depth Experience & Understanding of Coverage & Reimbursement, Member Enrollment, Provider Contracts, Benefits and Authorization and Claims Workflow
"A la Carte" Style Benefits
3+ Years of Experience in Data Analysis, Claims Configurations within QNXT or Similar Software/Application
$50.00 - $55.00 / Hourly Rate
Estimated 6 Month Contract Period
Paid Time Off / Sick Leave / Etc.
Medical Claims Processor Jobs
By NLB Services At United States
• COB and benefit summary knowledge
• Pay or deny claims according to the benefit summary
• Priority will be given to those with knowledge of the QNXT systems and application
• Knowledge of Medicaid, Medicare or commercial claims processing
• Experience with claims or customer service in medical field
Years of Experience: 2.00 Years of Experience
Healthcare Claims Processor Jobs
By Reqroute, Inc At United States
• COB and benefit summary knowledge
• Pay or deny claims according to the benefit summary
• Priority will be given to those with knowledge of the QNXT systems and application
• Knowledge of Medicaid, Medicare or commercial claims processing
• Experience with claims or customer service in medical field
• Review membership eligibility for determination
Healthcare Claims Specialist - Remote | Wfh
By Get It Recruit - Healthcare At Little Rock, AR, United States

We are a dynamic organization seeking a skilled and dedicated Medical Claims Specialist to join our team for a remote contract position. With a strong possibility of extension, we offer a rewarding ...

Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Duluth, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Acworth, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Smyrna, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Avondale Estates, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Stone Mountain, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Decatur, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Alpharetta, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Suwanee, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Roswell, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Norcross, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Clarkston, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Claims Processor Ii- Medi-Cal (Remote)
By Inland Empire Health Plan At , Rancho Cucamonga
ICD-9 and CPT coding and general practices of claims processing. Prefer knowledge of capitated managed care environment.
Major Functions (Duties and Responsibilities)
Major Functions (Duties and Responsibilities) Cont
Two (2) years experience in examining and processing medical claims; professional or institutional.
Medicare/Medi-Cal experience preferred. Claim adjustments, provider appeals and/or disputes preferred.
Microcomputer skills, proficiency in Windows applications preferred. Excellent communication and interpersonal skills, strong organizational skills.
Claims Processor Ii (Part-Time)
By BlueCross BlueShield of South Carolina At Greenville, SC, United States
2 years of experience processing, researching, and adjudicating claims
Strong organizational, analytical and judgment skills
Strong oral and written communication skills
5 years-of experience processing and adjudicating claims
CES, CORDS, OR AMMS experience
Knowledge of mathematical and statistical concepts