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Medical Claims And Appeals Examiner Jobs

Claims Examiner I - Medical
By EMI Health At , Salt Lake City, 84107, Ut

EDUCATION, EXPERIENCE AND OTHER SPECIFIC QUALIFICATIONS:

LANGUAGE, MATH, COMPUTER, AND REASONING SKILLS:

Assistant Medical Examiner (Medical Examiner Office) Actively Recruited - Seiu 20
By Cook County Offices Under the President At , Chicago, Il $256,081 - $294,461 a year
KNOWLEDGE, SKILLS, ABILITIES AND OTHER CHARACTERISTICS
Board certification in Anatomic, Clinical and Forensic Pathology at time of hire.
This position requires successful completion of post-offer tests, which may include a background check, drug screen and medical examination.
Must provide proof of certification or eligibility
Pre-Interview License and Certification Verification
Proficiency in Power Point and Microsoft Office® software programs.
Denials/Medical Appeals Specialist
By Lahey Health Shared Services At , Burlington, Ma
Required Education: High School Diploma
Preferred Licensure, Certification & Registration: Medical Billing Certification
-To be eligible, you must be a non-BILH employee or a previous eligible employee who returns to BILH after 1 year.
-Previous employees returning within 1-Year are eligible for a retention bonus.
-Employee must be in good standing to receive the bonus at the time of payment.
-All bonuses are subject to applicable taxes. This program is subject to change at any point
Pl Claims Examiner - Medical Claims
By JCW At Florida, United States
Manage healthcare professional liability claims from start to finish
Minimum of two years of specialized experience in legal or medical field, preferably in professional liability
Strong interpersonal, negotiation, and analytical skills
Excellent communication, writing, and organizational skills
Conduct investigation, coverage analysis, and work with defense counsel
Control legal expenses and provide technical expertise throughout the claim process
Facets Claims Examiner - Remote
By NTT DATA Services At Philadelphia, PA, United States
Confirm to the required regulatory and compliance requirements such as the HIPAA.
Confirm to the organizational and client training requirements
Demonstrate knowledge of internal operations and develops relationships to facilitate workflow.
Knowledge of related regulations and standards.
3+ years of full cycle claims processing experience in a Health Plan setting (Pay, Pend, Deny)
1+ year of experience processing claims in Facets
Claims - Express Claims Examiner
By The Cincinnati Insurance Companies At Fairfield, OH, United States
Customer service experience or prior management or leadership experience beneficial.
Knowledge or experience with Microsoft® Office and Excel preferred.
Deliver an excellent customer service experience through telephone and e-mail communication.
Accurate and efficient keyboarding skills.
Excellent written and verbal communication skills.
Prior experience in an office setting either fully in-office or hybrid helpful.
Claims Examiner Jobs
By Paramount Health Care At Toledo, OH, United States
Responsible for providing workers’ compensation third party administration claims management to Stated-Funded and self-insured employers.
·Participates in other departmental activities as directed by the department manager/director.
1. Previous workers’ compensation experience.
2. Knowledge of medical and legal terminology.
·Assist legal counsel in preparation of Workers’ Compensation cases and attendance at Workers’ Compensation Hearings if necessary.
·Participate in monthly/quarterly claim review with Employers providing detailed reports and claim reviews.
Medical Claims Examiner Jobs
By Flex Employee Services At United States
Title: Medical Claim Examiners-Long Term Care - 100% Remote
Pay Rate: $32-$40 per hour (based on experience)
Minimum 2 years previous experience in long term care or disability claims experience or equivalent.
Hours: M-F 8:00 am – 5:00 pm
# of Positions Needed: 15
Claims Examiner I Jobs
By Western Growers At Irvine, CA, United States
A minimum of one (1)year experience as a Claims Examiner for medical, dental claims and vision, subrogation, and accident claims
Ability to interpret Plan Documents or Summary Plan Descriptions (SPD) for the purpose of accurate claim adjudication and/or benefit determination
Basic knowledge of medical terminology. Familiar with UB-04 and HCFA 1500 forms (837/5010 format), ICD10, CPT, and HCPCS codes.
Good verbal and written communication skills.
Working knowledge of Employee Retirement Income Security Act of 1974 (ERISA) claims processing/adjudication guidelines.
Ensure compliance with all appropriate policies and practices, local, State, Federal regulations and requirements regarding claims and contract administration.
National Claims Examiner Jobs
By UPCIC At , Fort Lauderdale, Fl
Manage workload and provide management with reports for late reporting according to established UAC guidelines.
Rely on training and guidance from management to plan and accomplish goals.
Possession of other state license as required by management.
Required Knowledge, Skills & Ability
Knowledge of multiple policy forms.
Working knowledge of Microsoft Office including Word, Excel and Outlook.
Claims Examiner Ii - Evicore - Remote
By The Cigna Group At United States
Use your knowledge of medical terminology, health insurance plans and medical billing concepts
2 + years of experience with claims processing and/or medical billing - Required.
2+ years of experience with medical terminology and ICD and CPT codes Required
Proficient in data entry and Microsoft Office Products (Word, Outlook, Excel) - Required.
Image one and/or MC400 experience preferred
Review, evaluation and processing of medical claims
Seasonal Storm Claims Examiner
By Farm Bureau Financial Services At , West Des Moines, 50266, Ia
College degree or equivalent required. Experience handling property claims is preferred.
Must have experience with property estimating and construction nomenclature.
Proficiency with Xactimate is required, while XactAnalysis experience is preferred.
Strong customer service skills, including excellent verbal and written communication skills are required.
Must have excellent problem solving, analytical and organizational skills.
Ability to work under pressure and shift priorities to organize and process work with limited supervision under tight deadlines is required.
Claims Examiner Jobs
By Royal Etiquette Services At San Mateo, CA, United States
Strong communication and interpersonal skills to effectively interact with clients and gather information.
Excellent organizational skills with meticulous attention to detail.
Ability to work independently and manage time effectively.
Ensuring accurate and thorough case reports.
Conduct in-person visits to clients' homes to gather accident information, close cases, and perform accident investigations.
Set up a rapport and effectively communicate with clients to collect relevant details and understand their perspectives.
Associate State Medical Examiner
By State of Iowa Talent Gateway At , Ankeny, 50023, Ia $109,408 - $292,094 a year
Participates in appropriate continuing education in order to maintain expertise and licensure.
Maintains complete records of all relevant information concerning deaths or crimes requiring investigation by the State Medical Examiner.
Creates a report on performed postmortem examinations in a timely and accurate manner.
Reviews medicolegal records and uses ancillary tests and consultations when appropriate to complete reports.
Testifies in court and depositions regarding findings and conclusions of postmortem examinations.
Discusses with legal next of kin explaining findings from death investigations.
Claims Examiner I - Evicore - Remote
By The Cigna Group At Bloomfield, CT, United States
Use your knowledge of medical terminology, health insurance plans and medical billing concepts
1 + years of experience with claims processing and/or medical billing - Required.
1+ years of experience with medical terminology and ICD and CPT codes Required
Proficient in data entry and Microsoft Office Products (Word, Outlook, Excel) - Required.
Image one and/or MC400 experience preferred
Review, evaluation and processing of medical claims
Medical Disability Examiner Jobs
By The State of Florida At , Miami, 33186, Fl $40,740 - $71,087 a year
Required Knowledge, Skills, and Abilities:
Annual and Sick Leave benefits;
Knowledge of the principles and techniques of effective communication.
Ability to collect, evaluate and analyze data relating to disability benefits.
Ability to understand and apply applicable rules, regulations, policies and procedures relating to disability benefits.
3) Experience working in a medical or vocational field
Hospital Denials/Medical Appeals Specialist
By Beth Israel Lahey Health At , Burlington, Ma
Required Education: High School Diploma
Preferred Licensure, Certification & Registration: Medical Billing Certification
-Bonuses are paid out within the first 30 days of hire.
-To be eligible, you must be a non-BILH employee or a previous eligible employee who returns to BILH after 1 year.
-Previous employees returning within 1-Year are eligible for a retention bonus.
-Employee must be in good standing to receive the bonus at the time of payment.
Provider Non-Contracted Appeals And Claims Analyst
By Mediant Health Resources At Los Angeles, CA, United States
Proven problem-solving skills and ability to translate knowledge to the department
3+ years’ experience processing Medicare Advantage provider appeals from all types of providers (hospitals, physicians, ancillary)
3+ years’ experience in examining all types of medical claims, preferably Medicare Advantage claims
Working knowledge of claims processing systems (EZCAP preferred)
Working knowledge of medical terminology, standard coding and reference publications, CPT, HCPC, ICD-9, ICD-10, DRG, etc.
Familiarity with billing and coding edits, coordination of benefits, MA Organization, Determination, Appeals and Grievance procedures
Tdi-Claims Examiner I Jobs
By Texas Department of Insurance At Dallas County, TX, United States

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Claims Examiner I (Remote Option)
By Marshfield Clinic At Marshfield, WI, United States
Utilizes core systems and applications to appropriately finalize claims.
Refers to and complies with documented internal procedures and policies to ensure accurate claim processing.
Communicates with providers and internal departments by phone, email and/or mail correspondence to deliver high quality customer service.
Meets department productivity and quality measures to ensure accurate and timely claim processing.
Regular attendance is required in order to carry out the essential functions of the position.