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Screen, code and key claims in claims system. Ensure claims are processed in a timely manner. Description 80% Screen, code and key claims to ensure proper and accurate adjudication of claims in accordance with departmental standards for quality and production, contract regulations, policies and guidelines. 10% Correct keying errors as noted by system edits. 10% Accurately use medical review
Posted 1 day ago
Responsible for responding to customer inquiries. Inquiries may be non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description 45% Ensures effective cus
Posted 1 day ago
Q.B.E North America
- Sun Prairie, WI / Topeka, KS / Missoula, MT / 59 more...
Respond to crop claims by completing field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments and administering insurance policies to ensure compliance with state and federal regulations. Primary responsibilities Complete field inspections, reviews and adjustments by reading maps and aerial photos, measuring fields and storage bins, an
Posted 1 day ago
The Veterans Affairs Claims Processor will process and develop Veteran Administration (VA) claims for missing information in accordance with VA regulations and guidelines. In this role you will Correct payment errors on a post processing basis, including edit resolution, credits, additional payments, statistical adjustments, and recoupments. Analyze claims to determine if eligibility requirements
Posted 2 days ago
& Overall Relevance for the Organization Research and resolve customer deductions and to reconcile credit and debit balances on a customer's account. Identify customer's behavioural patterns to prevent a loss of income for the adidas Group. Maintain communications with Customers, Customer Service, Logistics, EDI, Compliance, Sales, Finance, and other various departments in the organization. Key Re
Posted 1 day ago
Change Healthcare
- Baltimore, MD / Lexington, KY / Cheyenne, WY / 47 more...
Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities. Here at Change Healthcare, we're using our influence to drive positive changes across t
Posted 1 day ago
Change Healthcare
- Baltimore, MD / Lexington, KY / Cheyenne, WY / 53 more...
Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities. Here at Change Healthcare, we're using our influence to drive positive changes across t
Posted 1 day ago
Change Healthcare
- Baltimore, MD / Lexington, KY / Cheyenne, WY / 49 more...
Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities. Here at Change Healthcare, we're using our influence to drive positive changes across t
Posted 1 day ago
Responsible for submitting stop loss claims to our reinsurance carriers. Coordinates with claims and membership to obtain required supporting documentation for stop loss reimbursements. Maintains/provides status updates via reporting, logs, and the stop loss database of all outstanding submissions. Description 65% Monitors aggregate and specific claims experience by use of specific analysis,
Posted 1 day ago
Responsible for submitting stop loss claims to our reinsurance carriers. Coordinates with claims and membership to obtain required supporting documentation for stop loss reimbursements. Maintains/provides status updates via reporting, logs, and the stop loss database of all outstanding submissions. Description 65% Monitors aggregate and specific claims experience by use of specific analysis,
Posted 1 day ago
Assists providers in understanding the CMS HC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding. Monitors Stars quality performance data for providers and promotes improved healthcare outcomes Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation /
Posted 19 days ago
Assists providers in understanding the CMS HC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding. Monitors Stars quality performance data for providers and promotes improved healthcare outcomes Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation /
Posted 19 days ago
Assists providers in understanding the CMS HC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding. Monitors Stars quality performance data for providers and promotes improved healthcare outcomes Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation /
Posted 19 days ago
Change Healthcare
- Baltimore, MD / Lexington, KY / Cheyenne, WY / 49 more...
Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities. Here at Change Healthcare, we're using our influence to drive positive changes across t
Posted 1 day ago
Change Healthcare
- Baltimore, MD / Lexington, KY / Seattle, WA / 35 more...
Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities. Here at Change Healthcare, we're using our influence to drive positive changes across t
Posted 1 day ago
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