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The Medicaid Billing Specialist is responsible for the accurate and timely editing, preparation, submission of electronically and manually processed claims to third party payers in accordance with policies and procedures.
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Business Analyst/Scrum Master with experience in Azure DO, Jira, Confluence, and claims experience, you are looking for a professional with a specific set of skills and knowledge. Knowledge of underwriting, claims processing, policy administration, and regulatory compliance.
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ESIS is seeking an experienced workers' compensation claims representative for the Glen Allen, VA office. ESIS Workers Compensation Claims Representative. Qualified candidates must possess experience in managing workers' compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation.
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Ability to assist with technical training to team claim handlers as requiredWell developed and advanced expertise and knowledge in most technically complex claims topicsPolicy language skills enabling accurate and consistent policy wording interpretationExperience in effectively following up on recommendations from technical claims audits and continuous file handling improvement.
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Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
$81,000 - $133,700Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Assists in keeping the environment safe for associates to reduce the occurrence of Workers’ Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated.
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4 years experience with Guidewire Cloud Claims migration. 4 years of experience working in one of the following sub service areas: Insurance Products, Underwriting, Claims, Billing & Payments, Policy Administration or Distribution.
$127,950 - $208,250 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Basic understanding of 1st and 3rd party fraud (claims to charge-off timing, chargeback recovery rights, etc.) Partner with claims, policy, strategy, and product teams to deliver data insights and analysis that inform critical decisions and help achieve goals.
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Catholic Mutual Group has an excellent opportunity for a Claims/Risk Manager (CRM) for our service office in Richmond, Virginia. The successful candidate will receive and adjust property/casualty claims by performing investigations/site inspections, evaluating liability, verifying coverages, and negotiating fair and equitable settlements.
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Including leading internal investigations, providing information on company policies, providing resources on leave options and reasonable accommodations when applicable, participating in unemployment hearings, managing any workers compensation claims and OSHA reports with the assistance of Safety and Security Manager, etc.
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We are looking for a Director software Engineering to lead our modernization journey of Fraud disputes and claims processing. Software Engineering - Fraud disputes and claims. We are looking for a Director software Engineering to lead our modernization journey of Fraud disputes and claims processing.
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To make all of this happen, we have great people with diverse skill sets - including underwriters, sales teams, claims professionals and risk managers - all collaborating and working together with a common goal of improving the experience for every customer in the Berkley Mid-Atlantic enterprise.
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Coordinates or oversees scheduling of in-house ancillary medical services, such as podiatrist, doctor visits, dental visits, psych visits, lab, X-ray, ambulance, etc. Requirements: A registered nurse, licensed practical nurse, or licensed vocational nurse from an accredited nursing program licensed to practice as required by state regulations.
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Attaches appropriate documents when billing manual claims including ER reports, itemized bills, implant invoices and other medical records. Submit adjustment claims to Medicaid through use of online systems.
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Qualified candidates ideally have prior experience handling fire, water, smoke, and natural disaster claims in the restoration/mitigation industry. Benefits: Pay is up to $24 per hour, based off experience and any IICRC certificationsPaid vacation timeSix paid holidays: New Year's Day, Memorial Day, July 4th, Labor Day, Thanksgiving Day and Christmas DayCompany vehicle provided to lead technicians during work hoursEligible for health, dental, and vision insurance after 30 daysPossibility for overtime hoursResponsibilities:Professionally represent the company’s mission, vision, and values.
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claims job Title: claim in Mechanicsville, VA
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