Claims Processor II

Job Description SummaryThe Patient Access Services Representative reports to the Patient Access Services Supervisor. Under general supervision, the Patient Access Services Representative provides high level customer service while facilitating accurate and timely completion of registration verifying and preparing all patient accounts for inpatient and...

Remote Claims Processing Associate NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.In this role, the candidate will be responsible for:Processing of professional claim forms files by providerReviewing the policies and benefitsComplying with company regulations regarding HIPAA, confidentiality, and...

Broadway Ventures is seeking a dedicated Registered Nurse (RN) to join our Medical Review team in a remote role. You will conduct pre- and post-payment medical reviews to ensure criteria compliance, assess medical necessity and reimbursement eligibility, and document decisions per regulations. Ideal candidates have an active RN license in the U.S., two years...

Contract Claims And Appeals Processor Sana's vision is to make healthcare easy. All of us can agree healthcare is simply too hard in the US. And our members feel that pain day in and day out. We aim to create an experience that simply feels easy when you need to access our healthcare system. If you need something, you know where to go to get it with care...

GeBBS Consulting is a healthcare technology professional services and consulting firm based in Towson, Maryland servicing clients throughout the US. We are celebrating our 29th year in business. We have two divisions: 1) Hospital / Provider Practice 2) Managed Care / Payer Practice – we work directly with health plans (very strong in the Blue Cross Blue...

Claim Representative II This is the intermediate level of the claim handler career path. Handles moderate difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.RESPONSIBILITIES/TASKS:Verifies...

Claim Representative II This is the intermediate level of the claim handler career path. Handles moderate to difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Works remotely with...

Job Title Responsibilities Review hospital claims and determine action needed to resolve pended claims Process and evaluate hospital claims manually or through claims work flow Validate information entered in hospital claims module (QNXT); determine the process or work flow needed to resolve discrepancies Finalize hospital claims by applying knowledge of...

Claim Representative II This is the intermediate level of the claim handler career path. Handles moderate difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.RESPONSIBILITIES/TASKS:Verifies...