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10+ years of Back Office (REG E claims, Return Item Processing, Check Adjustments, ACH Exceptions and Cash Vault and Research, etc.) Responsible for supervising and coordinating duties and work functions in the Centralized Processing department which includes, but not limited to: Exceptions Desktop Non-Post, Overdraft and Stop Payment processing, Chargebacks, ACH & POS/ATM Reg E Disputes, POD Adjustments, Cash Vault Balancing, Correspondent Bank Adjustments, Foreign Item Collection, Bank by Mail, In-house Lockbox processing etc.
$85,000 - $115,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Leverage emerging scientific and technological developments to generate new research ideas, solutions, and initiatives using real-world data (electronic health records, insurance claims, registry data, others.
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A recent or almost completed Ph. D. degree or equivalent experience in a quantitative field (e.g., biostatistics, epidemiology, artificial intelligence, computer science, operations research, statistics, industrial & systems engineering, applied mathematics, health economics, biomedical informatics, or similar.
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Additional responsibilities include processing warranty claims, conducting research for fleet defect resolutions, locating parts with parts shortages status, and communicating with manufacturer's Technical Support Team to perform complex repairs and perform preventive maintenance on a predetermined schedule to County vehicles (passenger vehicles, ambulances, law enforcement vehicles, transit vehicles, and mobile dental clinic) and other mechanical equipment.
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Research operational issues as reported by Clinical Operations, Markets, Provider Contracting, Market Clinical-Sr. Products, Provider Relations and member support areas as it relates to authorization processing and claims payment.
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By utilizing statistical methodologies and data visualization tools, the data scientist interprets complex data sets to generate actionable recommendations for enhancing the efficiency of pharmacy claims processing, detecting potential fraud, and improving patient outcomes.
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The responsibilities of the Bilingual Claims Examiner consist of processing claims data and adjudicating medical and inpatient claims received from all provider types and lines of business, reviewing and resolving rejected and/or denied claims, conducting research and analysis of claims and facilitating resolution of specific claims issues.
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Job DescriptionJob DescriptionJob DescriptionBilingual Medical Claims Examiner, English and Spanish Required The responsibilities of the Bilingual Claims Examiner consist of processing claims data and adjudicating medical and inpatient claims received from all provider types and lines of business, reviewing and resolving rejected and/or denied claims, conducting research and analysis of claims and facilitating resolution of specific claims issues.
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Outcome Analysis: Research to seek answers to relevant clinical, operational, & financial questions, and identify areas for improvement. WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office.
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The Senior Billing Assistant has experience in claiming medical services to either governmental or commercial insurance carriers including payment posting, claims follow-up, and denial research and resolution.
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A Grant Revenue Cycle Biller contributes to AHF by reviewing and processing claims daily, making necessary updates based on specific grant requirements. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.
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Knowledge of databases, data structures, data processing and data mining from large enterprise transaction systems Epic, Infor/Lawson, McKesson HPM, Payer Claims or similar applications in healthcare or other industries.
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Extensive hands-on experience implementing data migration and data processing using Azure services: ADLS, Azure Data Factory, Azure Functions, Synapse/DW, Azure SQL DB, Event Hub, IOT Hub, Azure Stream Analytics, Azure Analysis Service, HDInsight, Databricks Azure Data Catalog, Cosmo Db, ML Studio, AI/ML, etc.
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Assists in processing paperwork associated with clinical care including: insurance claims, disability forms, and medical equipment forms. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care.
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Demonstrate emerging scientific and technological developments to generate new research ideas, solutions and initiatives using RWD including but not limited to electronic health records, insurance claims, and registry data.
$120,000 - $143,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago
claims processing research jobs
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