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The Billing & Accounting Specialist will be responsible for accurately processing billing documentation, handling claims, ensuring compliance with Medicare and Medicaid regulations, and assisting with accounting related tasks.
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Claim Management: Handle claims submission, review denials, and coordinate appeals with insurance providers. Process Billing Documentation: Accurately process invoices, statements, and claims for senior living homes' medical services.
Full-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Three to five years previous experience working with medical billing and/or insurance claims processing, medical coding and terminology required. Facilitates, Claims Scrubbing of charges before sent to insurance.
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Experience in retail banking, claims processing, or document processing. Experience processing disputes/chargebacks, representments, and additional chargeback processes with Mastercard and VISA.
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These duties include, processing monthly skilled nursing facility claims for Medicare, Medicaid, Private payers and third-party insurances, posting insurance payments, working denials, and ensuring current A/R for assigned facilities is accurate.
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You’ll be challenged to thoroughly to learn multiple EFT networks’ rules and regulations, multiple computer systems, and utilize your knowledge to accurately and efficiently investigate cardholder debit card dispute claims for our member financial institutions.
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Do you enjoy assisting clients by performing research to provide a resolution quickly and accurately to their debit card dispute claims? Work with other team members and departments to resolve client and consumer claims.
Full-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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Knowledge of insurance claims processing, third-party reimbursement principles, and concepts. Researches and resolves 90+ day insurance claims monthly. Responsible for a variety of payment processes including, transferring payments across transaction, accounts, and data bases, overseeing balancing of payments posted to the accounts receivable system, entering and tracking returned checks, and processing payments.
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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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5 years of work experience in pricing or financial analysis using large data sets and complex SQL queries, including 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field.
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Job DescriptionJob Title: Agribusiness Claim Assistant Department: Agribusiness Reports to: Agribusiness Claim Manager Classification: Exempt Date: 04/01/24 Purpose: Assist with claims processing and to perform other tasks to ensure the efficient operation of the Agribusiness Claims Department.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Enter Clinical Review determination into the claims processing system(s) Prepare clinical review documentation for review by a MedOne Clinical Pharmacist. Update Clinical Authorization Criteria and Clinical Review Request Forms under the direction of a Clinical Pharmacist.
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Plan, organize, review, and audit and the testing of Rain and Hail developed software, to include online processing quoting, and other tools as programming changes are integrated. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
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PRIMARY PURPOSE: To process payment checks received in accordance with company check processing guidelines; to process the regular monthly payment recovery files; to coordinate with collection agencies; and to support the Claims Recovery Team within company standards and industry best practices.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Processing of all disbursements for the Companies you are assigned through the invoice workflow system or interface files (claims, premium refunds, commissions). Handle the daily processing of disbursements for the Companies that we service while providing excellent customer service and maintain a high level of attention to detail.
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claims processing jobs in Des Moines, IA
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