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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 Today - UpvoteDownvoteShare Job
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The Manager, Claims Processing - Covered California is responsible for oversight and direction of claims and auditing activities of the Covered California (CCA) vendor and personnel.
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The position will ensure that claims processing procedures and controls are being followed by all Claims department personnel. We are seeking a qualified candidate for the Claims Processing Supervisor position.
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Two years of Workers' Compensation claims processing experience. Receives general supervision from the Workers' Compensation Manager and functional supervision from a Senior Claims Examiner.
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Extensive experience working with states’ claims processing systems (including MMIS), payment policy, payment systems, coding, billing, and compliance rules in Medicaid and CHIP; Knowledge and expertise in working with states’ claims processing systems (including MMIS), payment policy, payment systems, coding, billing, and compliance rules in Medicaid and CHIP.
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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.
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Advance level (minimum 5 years) of claims processing experience and understanding of medical, dental, FSA, HRA, transplant, coordination of benefits, Medicare, hospital, professional, subrogation, and accident claims required.
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Analyze and work with states' claims processing systems, including MMIS, payment policy, systems, coding, billing, and compliance rules in Medicaid and CHIP. Assess compliance with state and federal laws, policies, rules, and regulations.
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Combine in-depth analysis of business unit requirements and comprehensive understand of core system capabilities, knowledge of claim processing, provider and vendor setup, authorizations and business processes in order to determine optimal core system setup to process claims, case management, and grievance and appeals with a high degree of accuracy and auto-adjudication.
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This position is primarily responsible for adjudicating all medical and non-medical provider claims and submitting enrollments/disenrollment to Florida Medicaid and CMS. Position is key to PACE's revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring client enrollment for accurate capitation reimbursement from Medicaid and Medicare, generating accruals for Accounting.
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Experience in insurance verification, appeals negotiations and processing, billing/claims processing, data processing, and software operations in the health care industry; preferably in the wound care industry.
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Provide legal advice and guidance to healthcare organizations on revenue cycle management best practices, including optimizing billing processes, charge capture, and claims processing. The Associate Attorney is responsible for accurately and efficiently reviewing contracts, researching healthcare provider claims, thoroughly documenting investigation results, and identifying and implementing timely resolution strategies resulting in maximum recovery percentage rates and a minimal average lifecycle for all matters.
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As a Sterile Processing Technician at St. Luke's Woodlands Hospital, now part of commonSpirit Health formed between Catholic Health Initiatives (CHI) and Dignity Health, you’ll assist in patient care and preparation of surgical patients.
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Our client, the largest privately held third party claims administrator in the United States, is seeking a Workers Compensation Claims Examiner Level III. The ideal candidate will have a minimum of 5 years of experience in Texas Workers' Compensation Claims and hold a Texas Workers' Compensation Adjuster's license.
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Strong understanding of revenue cycle management processes, including charge capture, claims processing, and reimbursement methodologies. Epic certification in Resolute Professional Billing (PB) required, additional certifications preferred (i.e. Hospital Billing, Claims, Benefits Engine.
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claims processing jobs Company: Anthem
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