Rcm Denial Claims Analyst Lead

Job DescriptionJob DescriptionAllied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously...

We are currently hiring for a Claims Policy Analyst II to join BlueCross BlueShield of South Carolina. In this role as a Claims Policy Analyst II, you will interprets all directives and policies to establish processing guidelines for area of expertis Claims, Policy, Analyst, Processing, Senior Analyst, Project Management, Technology, Healthcare

Job DescriptionJob Description The focus of this position will be research and root cause analysis of claims / config issues with direct provider interaction and collaboration with our provider relations team. Additionally, the role will help with overpayment recovery, claims payment and adjustment projects, and reviewing proposed SAI concepts from PI and...

Job Description: Position is fully remote and will be a temp role through 3/31/23. Position has the option to go perm based on positive work. Candidates can sit anywhere in the US and schedule will be M-F 9AM-5PM local time. The training schedule will be M-F 9AM-5PM EST. Daily responsibilities will include the following: Candidates will be reviewing medical...

Job DescriptionJob DescriptionAllied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously...

Job Description Job Summary Job Duties Uses analytical skills to conducts research and analysis for issues, requests, and inquiries of high priority claims projects Assists with reducing re-work by identifying and remediating claims processing issues Locate and interpret regulatory and contractual requirements Tailors existing reports or available data...

Sr Life Claims Specialist Do you desire to make a difference? Are you a flexible team player, a hard worker and a quick learner looking for a new opportunity where each day is different? Do you have past life and annuity experience and a strong customer service mindset? If so, this could be a great opportunity for you! Who We Are:  At Farm Bureau...

Job Summary Responsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and requirements established by the Centers for Medicare and Medicaid KNOWLEDGE/SKILLS/ABILITIES Responsible for the comprehensive research and resolution...

Job Summary KNOWLEDGE/SKILLS/ABILITIES Trains staff on configuration functionality, enhancements, and updates. Works with internal and external stakeholders to understand business objectives and processes associated with the enterprise. Problem solves with Health Plans and Corporate to ensure all end-to-end business requirements have been...

Job DescriptionJOB DESCRIPTIONJob Summary Responsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and requirements established by the Centers for Medicare and Medicaid KNOWLEDGE/SKILLS/ABILITIES Responsible for the...

Job Title: Claims Customer Service Advocate Job Location: Columbia, SC Zip Code: 29201 Top 3/5 Skills: · Customer Service · Inbound/outbound call · Data Entry · Claims processing Job Responsibilities Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and...

Quality Control Analyst | Responsibilities and Metrics Are you looking for your next challenge? The Virtual Business Office Associates is the perfect balance of a diverse and growing workforce that still feels like home. Come join our best in KLAS Extended Business Office today! Hiring remotely from: FL, GA, TX, NC, SC, VA, KY, AL. FLSA Status:Non- Exempt...

As a Quality Assurance Analyst, under direct supervision, you will perform quality control audits, reviews, or monitoring of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, Quality Assurance, Assurance, Analyst, Operations, Monitoring, Processing, Healthcare, Business Services

Business Analyst12 + monthsColumbia, SCSCOPE OF THE PROJECT:The Replacement MMIS project is among the most complex IT projects taken on by the State's Department of Health and Human Services. This project is a multi-year effort to replace many of the State's aging Medicaid systems with modern technologies and supporting business operations.DAILY DUTIES /...

Job DescriptionJob DescriptionOur prestigious health care facility is looking for an experienced DMH (Department of Mental Health) Medical Billing Specialist to join our team. We provide state-of-the-art care and treatment options for our patients and their families.Job Description:The ideal candidate is a detail-oriented team player with excellent...

Job DescriptionJob DescriptionCLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers and adjusters in your area. This is an independent contractor position.We are seeking professional inspectors to join our...

Claims Service Representative 3 - MedpayThis position handles moderate to higher complexity claims matters involving material damage, property and / or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include investigation, evaluation, and negotiation of...

Job Summary Responsible for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid. KNOWLEDGE/SKILLS/ABILITIES Enters denials and requests for appeal into information system and...

Under the direction of the Manager of Third Party billing, perform third party research functions. Sort and mail all bills (HCFA 1500) attaching any required documentation needed to receive payment (i.e. EOB for other secondary insurance, cost invoice, operative notes, etc.). Review rejection/denials from insurance carriers to determine what actions have...

Job Description The role of Treasury & Risk Management analyst will be responsible for the day-to-day treasury and insurance related functions for MAT Holdings, Inc. (the Company).  Treasury responsibilities include facilitating bank activities, cash management, supply chain financing and treasury reporting.  Risk Management responsibilities include...