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The Grievance Resolution Specialist coordinates the Grievance and Appeal resolution process, responds to verbal and written Grievances and Appeals from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, and pharmacy and vision decisions.
$24.52 - $31.04 an hourTemporaryExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Tracks employee injuries and coordinates Workers Comp program including but not limited to: filing claims, processing medical bills for payment, maintaining OSHA log, assuring compliance with FMLA, compiling statistics, coordinating Temporary Transitional Work Program, and acting as a member of the SIMS Committee.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Processes claims based upon contractual and/or CalOptima Health's agreements involving the use of established payment methodologies, Division of Financial Responsibility, applicable regulatory legislation, claim processing guidelines and company policies and procedures.
Full-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Compiles and organizes medical records; distributes to Medicare Compliance nurses for analysis; and provides guidance and advice on processing claims based on nurses’ analysis. Great Place to Work®Most Loved Workplace® Forbes Best-in-State EmployerMedicare Specialist (Remote)PRIMARY PURPOSE: To coordinate, analyze and facilitate Medicare Compliance and Medicare Set-Aside (MSA) functions within the assigned team.
Full-timeRemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Analyzes lien notices for accuracy, communicates with the CMS to efficiently facilitate lien resolutions on claims and/or prepare MSA submissions in accordance with submission guidelines from CMS as assigned.
Full-timeRemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Duties include preparing and processing claims, clearing billing edits, claim validation and submittal, and receivable follow up (e.g. collections, payment review, denials management), and where applicable transfer of charges, record maintenance, ensuring accurate registration, and maintaining applicable documentation.
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LAUSD is currently seeking well-qualified candidates to fill a Workers' Compensation Claims Processing Specialist position. A Workers' Compensation Claims Processing Specialist participates in the claims processing activities of the Workers’ Compensation Section of the Division of Risk Management and Insurance Services.
$35.62 - $44.02 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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We are looking for a motivated performer to join our Business Office team as a Collections Specialist, with an extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, Commercial plans, etc.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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At least 2 years of relevant experience such as: SIU, healthcare fraud investigation, medical claim investigation, healthcare program integrity, data mining or analytics, healthcare claims payment processing, clinical experience, compliance, or certification as AHFI, CPC/CCP/CCS/CMC, or CFE.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Under close supervision, the Medical Billing and Coding Specialist is responsible for processing health insurance claims for services provided at all clinics. Job Title: Medical Billing and Coding Specialist.
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The Medical Billing Specialist will be responsible for Insurance Claims/Processing as well as Patient/Insurance Payment processing. Bethany Medical Center (BMC), a Multi-Specialty physician practice located in High Point, Greensboro, Winston-Salem, Kernersville, Mt. Airy and North Wilkesboro, is seeking a Full Time Medical Billing Specialist.
Full-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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The Payroll and Benefits Specialist will support the bi-weekly and semi-monthly payroll processing for both hourly and salaried employees, ensuring accuracy and timeliness. Manage short- and long-term disability claims and ensure compliance with ERISA, Cafeteria Section 125, COBRA, and ACA regulations.
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The Payroll and Benefits Specialist will assist in processing of bi-weekly and semi-monthly payroll, handling benefits enrollment and inquiries, and ensuring compliance with federal, state, and local regulations.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Triumph Foods also holds a 50 percent partnership in Seaboard Triumph Foods, LLC of Sioux City, Iowa, a primary pork processing plant. Christensen Farms is the largest shareholder of Triumph Foods LLC, a producer-owned primary pork processing plant in St. Joseph, Missouri.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Medical Billing and Coding Certificate or Degree in field, Certified Professional Coder (CPC), Nationally Registered Certified Coding Specialist (NRCCS) or Registered Health Information Technician (RHIT.
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claims processing specialist jobs
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