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Develop and maintain collaborative and liaison relationships with Blue Cross Blue Shield Association (BCBSA), Blue Cross Blue Shield (BCBS) Plans, HHS OIG, other carriers' anti-fraud professionals, law enforcement, and regulatory agencies.
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Medical Insurance (Blue Cross Blue Shield) Join a best-in-class team that has been certified by J.D. Power for providing personal lines customers with an exceptional Auto Claims Experience - 5 years in a row.
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Experience with real world healthcare claims data, such as Blue Cross Blue Shield, MarketScan, Optum, Medicaid and/or Electronic Medical Record databases. This position involves statistical tasks and data management associated with healthcare datasets, including clinically abstracted data from 70+ hospitals across the state of Michigan via the Obstetrics Initiative (OBI), survey data, and claims data from both private and public payers.
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Blue Cross/Blue Shield PPO. Company DescriptionChristensen Hsu Sipes LLP is an elite national practice insurance and litigation law firm providing claims advice and legal representation for global insurers and Fortune 500 companies.
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At Blue Cross Blue Shield of Massachusetts, our company promise is to always put our members first. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing.
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North Carolina State Health Plan administered by Blue Cross Blue Shield of NC. The Industrial Commission is also a court of original jurisdiction for litigating tort claims against the State under the North Carolina State Tort Claims Act. Additionally, the General Assembly has mandated the Industrial Commission to provide an adjudicated process for Childhood Vaccine-Related Injury claims, Compensation to Persons Erroneously Convicted of Felonies, and Eugenics claims.
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Contacts Medicare, Medicaid, Managed Care, Commercial, and Blue Cross Blue Shield to inquire on claims. This position is responsible for reviewing carrier denials from Medicaid, Medicare, Blue Cross Blue Shield, Managed Care, and Commercial Insurances.
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The wellness premium applies only to the Blue Cross Blue Shield Hospital Medical Group #14000 plan for non-Medicare eligible active and retired members, non-Medicare-eligible members on LOA or COBRA, and non-Medicare-eligible spouses on active or retired contracts.
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Ability to read, analyze and interpret business documents such as HMSA's Medical Policy Manual, plan certificates and Guide to Benefits, statistical data, product development memos and documents published by Blue Cross and Blue Shield Association related to compliance; the literature from Federal and/or state governments pertinent to the business.
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Coordinate testing with Inter-Plan partners and execute required Inter-Plan Release Global Certification/Partner Plan testing, reporting milestone status to the assigned Project Manager and/or Blue Cross Blue Shield Association (BCBSA.
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Experience with Blue Cross Blue Shield billing. Reviewing and working claims for denials, appeals, holds, etc., to ensure prompt payment and timely filing is not an issue.
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Attractive Health insurance plans Blue Cross Blue Shield PPO, HMO or HSA. Review first and third party pre litigation and litigation automobile claims for coverage and settlement.
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Horizon Blue Cross Blue Shield of New Jersey is an Equal. administrative claims data, EHR/EMR data, or complex relational health care databases with significant experience analyzing medical, pharmacy, and behavioral health claims data.
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Comprehensive health insurance through Blue Cross Blue Shield. For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management, provider contracting, claims processing, and quality management services.
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Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer.
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