Claims Manager

The Sr Claims Auditor ensures incoming claims are processed in accordance with policies, procedures and guidelines, as outlined by Leon Health and contractual agreements; within mandated timeframes; and according to rates as reflected in respective provider contracts. The Claims Auditor will be responsible for pre-payment, post-payment validations and the...

The Sr Claims Auditor ensures incoming claims are processed in accordance with policies, procedures and guidelines, as outlined by Leon Health and contractual agreements; within mandated timeframes; and according to rates as reflected in respective provider contracts. The Claims Auditor will be responsible for pre-payment, post-payment validations and the...

What you’ll do In a few words… Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning… The Darwin Claims Administration team provides high quality services to clients and beneficiaries and meets that standard by configuring timely...

What you’ll do In a few words… Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning… The Darwin Claims Administration team provides high quality services to clients and beneficiaries and meets that standard by configuring timely...

**Position Summary** **Duties and Responsibilities** - Conduct analysis around various claims payment processes to ensure accuracy of system configuration and provider payments. - Investigate and resolve problem claims, while focusing on improving errors and problems to prevent future occurrences. - Perform and execute various claims process testing...

Purpose of Position: This position will work closely with Credit and Collections, Sales Department, Traffic Claims to research open invoices, and to process pending open claims in a timely manner. In this role, will also maintain compliance with company guidelines, and will perform clerical duties as needed. Accountabilities: * Review, research, and process...

Purpose of Position: This position will work closely with Credit and Collections, Sales Department, Traffic Claims to research open invoices, and to process pending open claims in a timely manner. In this role, will also maintain compliance with company guidelines, and will perform clerical duties as needed. Accountabilities: * Review, research, and process...

Job Description Job Description Reviews all medical/surgical billings for reasonable and necessary charges. Examines coding of operative reports, procedures, and multiple and complicated surgeries. Performs hospital length of stay reviews to determine reasonable and necessary care, and appropriateness of stay. Recommends appropriate payments of dispute of...

Job Description Job Description COMPANY OVERVIEW: Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for a PIP Supervisor to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a...

Dolce&Gabbana , a leader in the world of luxury, has an exceptional opportunity within its in-house Beauty Division. Dolce&Gabbana Beauty is looking for a proactive, organized, multi-tasking and hands-on Customer Support Specialist, Claims and Dispute . A new pivotal role part of the Customer Service Team within the Supply Chain Division. This is a fantastic...

Position is posted on a continuous basis until a sufficient amount of qualified applications are received. Applicants who are interested in the position are encouraged to submit an application promptly; notice will not be announced prior to closing the posting. This position performs professional and analytical work managing, planning, implementing, and...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet. The University of Miami has a great opportunity for a Risk...

Manages Larkin Community Hospital risk management activities. Administers the risk management program to reduce the frequency and severity of events. Manages and analyzes risk management data and conducts educational programs. Gathers data for insurance renewal, assists with investigation and resolution of claims, and complies with risk management-related...

At THE COLLECTION, we provide a level of professional service that truly sets us apart from the rest. Our employees are a valuable resource and an essential part of why we can provide our customers with the best. THE COLLECTION is not your typical dealership; we have an extraordinary elite team of employees and we are looking to grow that team with...

At THE COLLECTION, we provide a level of professional service that truly sets us apart from the rest. Our employees are a valuable resource and an essential part of why we can provide our customers with the best. THE COLLECTION is not your typical dealership; we have an extraordinary elite team of employees and we are looking to grow that team with...

About Us: Indulge your passion for problem-solving and embrace the thrill of addressing risk head-on at Gallagher's global brokerage team. Join a family of diverse minds, united by a relentless pursuit of excellence. As part of our team, you'll be the architect of protection, safeguarding businesses and empowering their ambitions. Together, we'll build a...

The Revenue Integrity Data Specialist will report to the Manager of Revenue Integrity Management. The Revenue Integrity Data Specialist will work along with the pre-bill edit team to take appropriate action to resolve patient account issues preventing claims and communicate to the revenue cycle departments when changes need to be made.Estimated pay range for...

Responsible for working/editing daily download of assigned Governmental Program claims while adhering to all regulatory, contractual, compliance and BHSF mandates/guidelines. Optimizes timely transmittal of accurate and clean claims to achieve daily set thresholds. Protects payer filing deadlines by utilizing all available resources to resolve held claims....

Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Healthhasinternationally renowned centers of excellencein...

Job Description Job Description NOTE: Experience within the Behavioral Health Industry is required. This is a fully remote position, however we are recruiting specifically from the South Florida region. Position Summary Responsibilities involve billing of institutional and professional claims to various insurance companies/payers. The biller will audit and...