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Knowledge of managed care principles and practices with an emphasis in Grievance and Appeals and/or Claims or Utilization Management. During times of high volume work and/or staffing shortages, perform grievance and appeals case processing.
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Procurement and contracting principles, including NTB, Prequalification Application, and RFP preparation, bidding requirements, bid analysis, cost analysis, change order processing, stop notice processing, and claims processing.
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Reviewing, and recommending for approval, specifications, contracts, change orders, extensions, stop notices, claims, invoices, and closeout agreements. Do you want to work for an organization that manages an integrated water resources system that includes the supply of clean, safe water, flood protection, and stewardship of streams on behalf of Santa Clara County's 2 million residents.
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Working on multiple screens, hand-on with claims processing. Claims Adjudication / Adjustment. Determine accurate claims payment or denial, identify, and elevate dubious claims or system issues to process the claim accurately.
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Monitor equipment and tool warranty programs to insure warranty claims are forwarded to Asset Manager for processing. Assist Maintenance Manager in the repair and fabrication of equipment by performing basic to advanced welding techniques (MIG, TIG, ARC.
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Utilize electronic health records and claims processing systems. Proficiency in Microsoft Office Suite and experience with claims processing systems. Collaborating with internal teams, including claims, provider relations, and customer service, you will effectively resolve issues.
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Performs receiving duties such as receiving and unloading inbound material, processing inbound shipments and stock material, processing customer returns, and notifying management of damaged shipments for freight claims.
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Process expense claims, per-diem, and allowances \t. Assist in processing payroll weekly \t. Process certified payrolls through LCP Tracker and D Payroll Specialist, Payroll, Specialist, Accounting, Staffing.
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We are fully delegated by all major health plans to provide services including utilization management, quality improvement, credentialing, committee and board support, contracting with both health plans and providers, claims processing, provider and member services, marketing, IT support, and finance.
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ARM will serve as the key contact and lead for access and reimbursement support-related matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.
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Administers warranty claims, reviews warranty policy adjustments, understands and applies warranty guidelines, ensures correct processing of claims and communicates warranty information and clarifications to customers.
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ARM will serve as the key contact and lead for access and reimbursement support-related matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, and reimbursement.
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Access & Reimbursement Manager (ARM) - NPS CV - San Jose - Remote. The Access & Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide range of access and reimbursement topics and needs in support of aligned product(s) strategy.
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Do you want to work for an organization that manages an integrated water resources system that includes the supply of clean, safe water, flood protection, and stewardship of streams on behalf of Santa Clara County's 2 million.
$159,057.59 a yearFull-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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At least 1 year of claims processing experience or a strong knowledge of provider billing procedures. Collaborate with Claims, Medical Management, and Network Management departments to resolve member and provider issues.
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claims processing jobs in San Jose, CA
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