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VP, Data Delivery- Claims, Ops and Digital. Foundational understanding of Natural Language Processing, and Deep Learning. VP, Data Delivery- Claims, Ops and Digital. Build and maintain IAC (terraform/Cloud Formation), CICD (Jenkins) scripts, CodePipeline, uDeploy, & GitHub Actions.
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Identifying opportunities to streamline processes that directly impact accuracy, efficiency and integrity of patient billing and collections, including registration, charge capture, coding, documentation, and claims processing.
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Responds to all Plan and vendor OPL inquiries including ones submitted via FEP Hub. Directs and executes activities for the internal Medicare Primary Denial Workgroup to include initiation of new central claims processing controls, in response to OPM and Office of Inspector General (OIG) audit findings, and management of the long-term effectiveness of those changes.
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As directed, the Analyst/Sr. Analyst will perform a number of insurance and risk management activities that support the various business lines within PPL which include: insurance program renewals for property and casualty lines, captive insurance management, claims, contract reviews for a wide variety of risks, management of the surety bonding program, certificates of insurance processing, and involvement in any project that requires corporate insurance assistance.
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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 MediRegs portfolio.
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Experience Experience in travel and hospitality industry, insurance claims processing, or foreign language skillsare encouraged, but not required. Begin learning consultative sales techniques to uncover and resolve customer needs and answer questions regarding plan benefits and claims status.
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Must have 3-5 years of Claims and Insurance experience Associate's Degree preferred for this Medical Claims position Pay for this Medical Claims Specialist position 23 -25 per hour #CB #P2.
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Responsible for the day-to-day account management of an assigned book of business, including but not limited to processing policies/endorsements, invoicing, issuance of certificates of insurance, claims reporting and follow-up as needed, premium breakdowns, auto ID cards, policy changes, review of policy forms, providing coverage comparisons, loss analysis and responding to coverage questions.
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Participates in the collection and documentation of claims processing rules. Responsibilities include:Following policies and procedures, timely and accurately follows-up on claims for the resolution of outstanding balances, and denials, working directly with commercial and governmental payors to resolve denials and underpayments.
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Customer-centric employee: Conveying a calm, caring attitude, you will provide best-in-class service to customers while processing new claims. As a Claims Representative, you will become part of a fast paced, rewarding, and diverse team that appreciates the importance of a healthy work/life balance.
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Reconciliation of all monthly activity for premiums, claims, and reinsurance. Preparation and processing of accounts payable and accounts receivable oversight. Working directly with the Chief Financial Officer, the Senior Accountant will be involved in all accounting and reporting functions.
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As their Senior Account Executive, you’ll be responsible for overall account management functions for customers in your assigned territory including new business placement, review, negotiation, and processing of renewals, policy inquires, coverage reviews and claims and billing inquiries.
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Expertise in US Health Insurance Claims Processing (Mandatory). Reviewing claims processing policies and guidelines. WE are seeking a highly motivated and detailed oriented Claims Analyst to join our team.
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Record premium received as well as vendor payments, invoicing and commission payment processing. This is an entry-level position that will interact internally with: Underwriting, Actuarial, Claims, Compliance, IT, and externally with Occupational Accident’s business partners.
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The A&H Specialty Business Unit takes a forward-thinking, flexible approach to solutions that span a robust slate of products tailored to needs in Special Risk, International Travel Medical, retail and wholesale Travel and Occupational Risk. At year-end 2022, the SBU recorded $675M in gross premium written.
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claims processing jobs in Hartford, CT
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