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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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Job ResponsibilitiesConfirms coverage of claims by reviewing policies and documents submitted in support of claimsDirects and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savingsAnalyzes coverage and communicates coverage positionsPrepare coverage position letters on matters typically in litigation without assistance of outside coverage counsel.
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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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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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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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Ensure Proof of Claims, Motions for Relief, Payment Change Notices, Post Petition Fees and Costs are prepared by counsel, are accurate and all aspects of the bankruptcy are handled according to investor guidelines and timeframes.
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Under general supervision, the position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims.
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Bachelor's degree plus insurance claims experience, or a minimum 10 years of experience handling Commercial General Liability Claims. Current Claims Adjuster licenses in one or more states preferred but must be willing to obtain additional state licensures.
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Review primary and secondary claims to ensure correct billing codes and accuracy to avoid errors leading to denials. Investigate rejected claims and denials for resubmission. Knowledge of medical insurance claims.
$43,000 - $46,000 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Requires a HS diploma or equivalent and a minimum of 3 years of claims processing and customer service and 3 years COB experience that required using NAIC & CMS COB guidelines; or any combination of education and experience which would provide an equivalent background.
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Performs subcontract management post-award activities through evaluating and status contractors’ productivity, schedule adherence, contract change management, invoicing, and claims avoidance. TSR is looking for a Senior Procurement Specialist to negotiate favorable terms, discounts, and contracts with suppliers for the procurement of equipment, material and services.
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Currently seeking an experienced commercial Claim Specialist to provide quality, cost efficient, and timely investigation of liability claims. Responsibilities include maintaining an inventory of claims handled within departmental guidelines, following best practices policies and procedures and budgetary guidelines, field investigations, negotiating limited settlements, setting reserves, attending mediations and documenting all file activity.
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DUTIES AND RESPONSIBILITIESCoordinate daily benefits processing for our full-time employees and contractors for our Staff Augmentation division including: Benefits enrollments for U.S-based employees and contractors, COBRA, terminations, changes, beneficiaries, disability, accident and death claims, rollovers, distributions, loans, hardships and compliance testing.
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We are looking for a highly capable Subrogation Specialist to join our Claims Shared Services team and work from any US Argo office. This role will adjudicate subrogation auto and workers compensation claims using your specialized knowledge to evaluate liability in order to pursue, negotiate and resolve subrogation claims.
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The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel. This position will be in office (Glen Allen, VA office), initially, with hybrid options available after initial training period.
$15.98 - $25.69 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago
claims job Title: specialist in Mechanicsville, VA
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