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These systems and services help the two agencies determine client service program eligibility; provide medical, housing, food and job assistance; provide addiction, mental health, vocational and rehabilitative services; protect children, seniors and people with physical and/or developmental disabilities; process claims and benefits; manage provider licensing and state hospital facilities; and promote and protect the state public health.
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Duties And ResponsibilitiesClaims Processing & Quality Assurance Adjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD),outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe.
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A Brief OverviewThe Business Analysis Manager provides both operational support to, and analysis of, all Tapestry claims processing-related system configuration activities. The ACO Business Analysis Manager ensures successful configuration, integration, and accurate and timely payment of claims.
$52.64 - $69.74 an hourFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Office also offers skin care services including LaRoche Posay products, laser hair removal & Thermage skin tightening. Office also offers skin care services including LaRoche Posay products, laser hair removal & Thermage skin tightening.
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Assist when needed for charge entry, pulling operative notes, claims transmission and working claim rejections. This includes managing a team of 12-15 employees ensuring the accurate capture of all revenue, clean claims submissions both electronically or via mail, the management of Clearing House rejections, creating and administering ongoing training to staff, and upholding the integrity of the organization.
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Supervises outside vendors retained for investigations, cost containment, expert witnesses, and litigation management to ensure claims are being handled appropriately according to the applicable jurisdiction.
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Drives Operational metrics, including but not limited to the following: productivity, VBP, SVP, ACH, claims alert, late EMS, unverified services, orders audit, and agency financial statements to ensure the organization is on target with company goals related to operational efficiency, growth, quality, and finances.
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Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs other clerical duties, as assigned by the Pharmacy Manager.
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Routes correspondence to Claims Document Processing to obtain correct paperwork when needed. About the Job:If you’re passionate about helping people restore their lives when the unexpected happens, and providing the best customer experience, then our Mercury Insurance Claims team could be the place for you.
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A majority of the work activity involves field surveillance requiring the investigator to obtain high quality videotape documentation of claimants who have filed workers compensation and liability/personal injury claims.
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Who We AreWe’re Dealer Tire, a family-owned, international distributor of tires and parts established in 1918 in Cleveland, OH. We’re laser focused on helping the world’s largest and most trusted auto manufacturers grow their tire business—in fact, we’ve sold more than 60 million tires to date.
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Validate trade/rebate claims in SAP TPM against valid contracts and promotions in Salesforce. Expectation is to reconcile all claims timely before month end report outs. Validate trade/rebate claims in SAP TPM against valid contracts and promotions in Salesforce.
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Example of work at this level include filling prescriptions utilizing automated dispensing equipment; distributing pharmaceuticals; utilizing pharmacy-based computer systems; working with insurance claims to bill for pharmaceuticals and resolve any billing issues; and performing pharmaceutical procurement and inventory management.
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Manages all aspects of the Verint application, including Associate Profiles, Time Off Management, Integration files for accuracy in Claims queue management, and more. Uses Analysis to create and communicate daily forecasts that show Claims volume by age and make recommendations that are essential in meeting our Time to Pay goals.
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Will need a minimum of 5 years commercial general liability claims experience and at least 2 years experience in Construction Defects. Third Party Administrator is looking for Construction Defect Claims professionals.
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laser claims jobs in Oregon, OR
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