- Acosta Group (Jacksonville, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- AmeriHealth Caritas (Washington, DC)
- …Provider Network Resolution Analyst is responsible for configuration updates, resolution of claims inquiries, and all other system changes needed to ... facilitate timely and accurate payment of claims for par and non-par providers in our network.;...providers in our network.; The Managed Care Provider Network Resolution Analyst ensures that each provider's status… more
- Molina Healthcare (San Antonio, TX)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... as applied to the appropriate modules within the core claims processing system (QNXT). * Conducts high dollar, random...communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance. * Helps… more
- Molina Healthcare (Flint, MI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... claim payment system and other applicable systems. + Participates in defect resolution for assigned component + Assists with development of configuration standards… more
- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary… more
- Adecco US, Inc. (Las Vegas, NV)
- We are looking for a Compensation Claims Analyst For a company that supports and administers claims adjustments for self-insured companies that do not have ... department. **We Offer:** Rate: $45.00 p/h On-site or remote M-F: 8 - 4:30 Short-term growth and development...**Essential Functions and Responsibilities:** + Investigate and process complex claims . + Develop action plans for timely resolution… more
- Cardinal Health (Nashville, TN)
- This Sr. Analyst will support the Metro Medical Pharmacy Claims & Reconciliations. Open to remote candidates in Tennessee and Ohio! **_What Finance ... services rendered to policyholders, identifying errors or overpayments. + Claims Reconciliation: This involves comparing claims submitted...ability to identify issues and able to recommend a resolution . + Clean up Project - AR Aging Research… more
- Ascension Health (Austin, TX)
- …insured and defense counsel. + Investigate and process general and professional liability claims from first notice of loss through resolution including coverage, ... Accounting + **Schedule:** Full-Time, 8-hour, Day Shift, Monday-Friday, Partially Remote + **Facility:** Ascension Care Management Insurance + **Location:** Austin,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …+ Analyze complex operational claim overpayment issues and provide technical resolution .; + Consistently meets or exceeds production standards for Claims ... + High School/GED required. + 1 to 3 years experience in Facets Claims System preferred. + In-depth knowledge of claims payment methodology **is… more