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The Warranty Claims Specialist is responsible for reviewing warranty, policy work orders, and the processing of warranty claims to original equipment manufacturers (OEMs). A Warranty Claims Specialist has moderate knowledge of warranty claims and OEM concepts, practices, and procedures; works under immediate supervision.
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Processes warranty claims, remittance, and variances as they pertain to OEM specific requirements for type of product. Assists Warranty Claims Specialist I with questions related to claim scenarios.
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Research and compose bi-weekly reports for management on current case assignment statistics by querying the database to determine the overall statistics for total cases, cases pending processing versus the final requests from the entire unit, sub-unit, and individual case worker.
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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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Design the APIs and integration models for IBM B2B Integrator with healthcare claims and financial X12 and HL7 processing. · Knowledge of financial payroll and accounting systems, electronic healthcare, and financial claims processing.
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The Workers Compensation Account Representative will assist and manage all aspects of patient processing and accounts receivable functions of the organization including billing, charge entry, collections, registration, eligibility, follow-up, payment posting, patient collections and credit balance resolution.
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Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer. Research claims inquiry specific to the department and responsibility.
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The Business Office Manager will also be responsible for oversight and processing of all accounts payable. Some of the other functions are: prepares daily census, reviews Payor Source Verification forms and ensures that the information entered in the patient’s setup in PCC is accurate, directs processing of accounts receivable adjustments/refunds, handles cash deposits, posts all cash and maintains the resident trust account including quarterly reports, and updates PCC with any changes in applied income.
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Collaborate with insurance providers, billing departments, and external stakeholders to ensure accurate and timely processing of insurance claims and payments. Familiarity with medical terminology, electronic health records (EHR) systems, and HIPAA regulations.
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Maintains a high level of integrity and commitment to accurate benefit verification and claims processing. Researches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.
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Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods involving Rx drugs.
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Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
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Fluid understanding of operations and/or claims processing. If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). Identifies at risk accounts and collaborates with management to set and execute a strategy to minimize loss.
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Assist with the unloading of trucks, processing of freight, execution of transfers, RTVS, claims, freight processing, etc. They define the behaviors that can drive our business while ensuring a great teammate and athlete experience.
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High school, plus specialized schooling and/or on the job education in a specific skill area; e.g. data processing, clerical/administrative, equipment operation, etc., plus 10 years parts sales experience.
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claims processing jobs in Oklahoma City, OK
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