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In-depth working experience in medical billing (long-term care or rehab), managing insurance, PDM (Medicare), Medicaid, VA, and private claims, as well as MDS, collections, and accounts receivable.
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Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Reviews and analyzes Physician/Allied Health/GME applications for initial appointment and reappointment and credentialing documents including clinical education/training, board certification and eligibility, licensure, accreditation, work history, liability insurance and malpractice claims history.
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ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services.
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A comprehensive medical billing course is defined as generally 300 hours of coursework which at a minimum covers medical terminology, current procedural terminology (CPT) coding, International Classification of Diseases (ICD-10) coding, Health Insurance Portability and Accountability Act (HIPAA), explanation of benefits (EOB), electronic billing/electronic data interchange (EDI), insurance claims and claim forms, Medicare and other payers as evidenced by a syllabus.
ExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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The Medical Billing Manager is responsible for the direction of daily operations and procedures that ensure that all insurance claims are coded and billed correctly as well as followed up on in a timely manner to ensure prompt resolution of the claims.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Verify the calculation of the monthly premium statements for all group insurance policies and maintain statistical data relative to premiums, claims and costs. Knowledge of all pertinent federal and state regulations, filing and compliance requirements, both adopted and pending, affecting employee benefits programs, including the ACA, ERISA, COBRA, FMLA, ADA, Section 125, workers' compensation, Medicare, OBRA, and Social Security and DOL requirements.
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Extensive knowledge of claims reimbursement and insurance collection practices (for Managed Care, Medicare/Medicaid, Workers Comp, etc.) This position ensures that all claims billed to the insurance or client are compliant with state and federal regulations, grant provisions or provider agreements, and all payments received are timely and correct.
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Experience in insurance verification, Medicare claims, Medicaid application process, Medicaid claims, accounts receivable, accounts payable and payroll. Assist families and/or patients with insurance, Medicare and Medicaid claims and statement questions.
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Background with Medi-Cal, Medicare, managed care, and PPO insurance. This will involve providing quality control checks on paper claims; processing tracers, denials and related correspondence; initiating appeals; and drafting, composing, and submitting appeal letters.
$26.85 - $35.41 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Medical Insurance Claims Analyst (Hybrid) MediCal, Medicare Advantage, and/or Commercial Claims Auditing Experience. 2+ Years of Healthcare and/or Insurance Claims Experience.
Starting at $24.28 - $36.39 an hourExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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5 years as an Appeals Specialist or equivalent experience in health insurance claims, customer service, billing, or related operations preferred. Job Description - Senior Appeals Specialist-Medicare Advantage (2400193.
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This individual will prepare and submit clean claims to Medicare, various commercial insurance carriers, and Self-Pay patients. The MBS will ensure timely, effective, and thorough management of claims to ensure full, expected reimbursement for services provided and will prioritize claims based on aging and outstanding dollar amounts or as directed by management.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Knowledge of the insurance industry preferably claims management relative to one or more of the following categories: workers' compensation, no-fault, liability, and/or disability. Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
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Ensures all federal ERISA and/or state mandates are adhered to at all times. Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
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