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Candidate for this role will provide key contributions to the development of exchanging activity/data between internal systems of record (including Admin, Policy, Claims systems, etc) and partner platforms (including Workday, ADP, Plansource, etc.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Reviewing and certifying disability claims and life insurance premium waiver applications for completeness, accuracy, and compliance with plan guidelines. The Disability and Pension Adjustment Units process benefits for members of the Public Employees' Retirement System (PERS) and Teachers' Retirement System (TRS), National Guard and Naval Militia Retirement System (NGNMRS), Unlicensed Vessel Personnel Annuity Retirement Plan (UVPARP), Judicial Retirement System (JRS), Elected Public Official Retirement System (EPORS), and the Defined Contribution Plans.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Claims Appeals Representative *Remote. 3 years Billing collections, or denials management experience and medical terminology. Required Qualifications: Associate's Degree Or equivalent combination of education and experience 3 years Familiarity with managed care contracting, provider operations and/or payer operations.
$25.72Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The Associate Director of Product Management, will have experience in healthcare revenue cycle management (RCM), the financial process healthcare facilities use to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation, to drive the overall vision and strategy of Wolter Kluwer’s.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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2) implementing documentation and source control using GIT-backed Azure Dev Ops; (3) constructing complex queries using SQL to pull data from a claims processing database; (4) programming language C# for application and API development using OOP concepts; and (5) unit testing frameworks (nUnit, SpecFlow, MSTest, xUnit.
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Management and execution of a variety of customer service and value-added service requests/inquiries including but not limited to: account activity; policy administration and insurance placement; billing activity; claims administration; coverage/loss analysis; contract review for insurability; review policy forms and endorsements; review audits; identify errors and facilitate corrective actions; Certificates of Insurance; Evidences of Property; and Cancellation/Reinstatements.
RemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Ally Mechanical Claims Specialist - French Speaking Only - Remote Alaska Apply Now Ally Financial only succeeds when its people do - and that’s more than some cliché people put on job postings.
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Promptly manage Workers Compensation Subrogation claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, litigation management, negotiating and resolution.
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Becomes familiar with all aspects of the application, including reports, parameters, claims management, intake services, carrier/client interfaces and vendor/business partner interfaces. Knowledge of client/server applications and claims management systems.
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Responsible for monitoring emerging medical, pharmacy, and LTSS claims compared to forecast and revenue. Provides guidance to Controller for month close related to membership and claims impacts to emerging MER and trend.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Responsible for quantifying and explaining the 'why' of where trends are unfavorable to budget and rate development and advising whether this is a rate issue for negotiation or a claims issue for operational initiatives.
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Train dental office staff on the use of automated services to ensure they utilize various means of automated communication, as well as, claims and electronic data interchange and electronic funds transfer.
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2+ years of experience with facets claims adjudication system and / or Optum CES editing software. Be responsible for monitoring changes to codes, coding guidelines and regulations, and coding edits from external agencies such as AMA, CMS, Medicaid, and specialty societies, and assists with implementation of such changes to the claims adjudication and editing software.
Full-timeRemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Provide industry expertise in cost management systems & project controls, including budgeting, documenting physical progress, documenting actuals, documenting commitments, contract management including managing changes and variations, payment applications and claims, measuring performance, supply chain management, calculating earned value, and analyzing reports.
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Manage and process Risk Management, Insurance Operations and Claims incoming digital mail. Partner with the COI team and Stop Loss in managing COI pre-default process for FMS customers to obtain a compliant certificate of insurance for lease customers or recommend termination for those lease customers that have not provided as required.
$73,000 - $83,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated 1 month ago
claims job in Juneau, AK
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