Healthcare Claims Compliance Specialist

Job SummaryWe are seeking a skilled Healthcare Claims Specialist to join our team at MedPOINT Management. As a key member of our claims department, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and contractual obligations.Key Responsibilities:Review and analyze incoming claims to...

Job SummaryWe are seeking a skilled Healthcare Claims Specialist to join our team at MedPOINT Management. As a key member of our claims department, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and contractual obligations.Key Responsibilities:Review and analyze incoming claims to...

Job Title: Claims Specialist - Quality Standards and ComplianceJob Summary:We are seeking a highly skilled Claims Specialist to join our team at Vista Del Mar Child & Family Services. As a Claims Specialist, you will be responsible for managing client information and funding eligibility of clients billed through the Los Angeles County Department of Mental...

Job Title: Claims Specialist - Quality Standards and ComplianceJob Summary:We are seeking a highly skilled Claims Specialist to join our team at Vista Del Mar Child & Family Services. As a Claims Specialist, you will be responsible for managing client information and funding eligibility of clients billed through the Los Angeles County Department of Mental...

Job SummaryA Hospital Claims Auditor is responsible for ensuring the accuracy and compliance of claims processes, adhering to regulatory requirements and contractual obligations. This role involves researching and resolving problem claims, suggesting process improvements, and providing training to staff.Key ResponsibilitiesAudit daily processed claims to...

Job SummaryAt Medix, we are seeking a highly skilled Medical Claims Specialist to join our team. As a Medical Claims Specialist, you will play a critical role in ensuring the accuracy and efficiency of our claims processing operations.Key ResponsibilitiesReview claims for accuracy and completeness, ensuring that all necessary information is included.Expedite...

Job Title: Medical Claims SpecialistVolt is seeking a highly skilled Medical Claims Specialist to join our team. As a Medical Claims Specialist, you will play a critical role in ensuring timely and accurate payment of medical claims.Key Responsibilities:Review and analyze medical claims to identify potential issues and discrepancies.Communicate with payors...

Job SummaryMedPOINT Management is seeking a highly skilled Medical Claims Specialist to join our team. As a Claims Examiner, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and company policies.Key Responsibilities:Review and verify incoming provider claims for accuracy and...

Job Title: Hospital Claims ExaminerMedPOINT Management is seeking a highly skilled and detail-oriented Hospital Claims Examiner to join our team.Job SummaryThe Hospital Claims Examiner will be responsible for the adjudication of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospital Client. This...

Job Summary:A skilled Billing Specialist is required to maintain a current understanding of billing and coding guidelines to ensure claims are consistently billed properly. The primary accountability for this role is to support Soarian Financials Billing Edits and Billing Processes for the company.Key Responsibilities: Review and resolve claim edits in the...

Job SummaryA Billing Specialist plays a crucial role in maintaining the organization's billing and coding practices to ensure accurate and timely claims processing. The ideal candidate will have a strong understanding of billing guidelines and regulations, as well as excellent analytical and problem-solving skills.Key ResponsibilitiesReview and resolve claim...

Job SummaryThe Medical Claims Specialist is responsible for the accurate and timely adjustment of hospital risk claims, ensuring compliance with regulatory requirements and contractual obligations. This role involves researching and reviewing claims, collaborating with providers and other departments to resolve issues, and suggesting process improvements to...

Job SummaryThe Claims Examiner position is a critical role within our organization, responsible for ensuring the accurate and timely adjudication of paper and/or electronically formatted claims received in the CMS 1500 and/or UB-04 format. This position requires a strong understanding of Medicare and Medi-Cal regulatory guidelines, contract provisions, and...

Job DescriptionWe are seeking a detail-oriented Medicare Claims Appeals Specialist with a comprehensive understanding of Medicare claims processing, including provider contracts, Division of Financial Risk (DOFR), explanation of benefits, and claim edits.Key Responsibilities:Review and process Medicare provider appeals cases for California clients, adhering...

{"title": "Claims Administrative Specialist", "description": "Job SummaryZenith Insurance Company is seeking a highly skilled Claims Administrative Specialist to join our team. In this role, you will provide administrative support to our claims team, ensuring the efficient processing of claims and excellent customer service.Key ResponsibilitiesIssue timely...

Job SummaryAs a Senior Claim Specialist at Chubb, you will play a critical role in resolving workplace claims in a collaborative and paperless environment. With a strong analytical mindset and excellent communication skills, you will work closely with defense counsel and insureds to negotiate settlements and resolve discrimination, harassment, and other...

Job SummaryThe Kheir Clinic is seeking a highly skilled Healthcare Compliance Specialist to join our Compliance and Credentialing team. As a key member of our team, you will be responsible for maintaining current knowledge of relevant compliance requirements, clinic operations, and managed care programs.Key ResponsibilitiesCollect, review, and verify...

Position OverviewThe role of a Healthcare Claims Analyst encompasses the evaluation and processing of claims, ensuring adherence to industry regulations and contractual obligations. This position requires investigating and resolving complex claims issues while proposing improvements to existing processes. The analyst also acts as a crucial resource for the...

Job SummaryThe Claims Examiner position is a critical role within our organization, responsible for ensuring the accurate and timely adjudication of paper and/or electronically formatted claims received in the CMS 1500 and/or UB-04 format.Key Responsibilities:Process all claims and applicable claims correspondence in accordance with Medicare and Medi-Cal...

Regulatory Compliance SpecialistChildren's Hospital Los Angeles (CHLA) is seeking a highly skilled Regulatory Compliance Specialist to join its Office of the General Counsel. The ideal candidate will have a strong understanding of healthcare regulatory landscapes and experience providing clear, practical guidance in structuring transactions, policies, and...