This position is responsible to assess insurance eligibility and benefits information and obtain required authorizations and medical necessity to ensure financial viability. Reviews all insurance eligibility responses for completeness. Achieves evaluation of reimbursement based on known factors. Communicates with the patient and their physician as needed regarding these r

The Financial Counselor is responsible for verifying benefits and eligibility for potential and actual patient admissions, for completing the actual admission/registration process required for the patient's admission to the hospital and for assisting in the preparation of the financial folder. The position is also responsible for providing patient financial counseling and

Under the direction of the Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and on time. Maintain a safe and professional environment for applicants, clients, and employees, perform with confidence all aspects of an insurance exam, including specimen collect

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Behavioral Health Registered Nurse Case Manager will report to th

Analyzes, configures, develops, tests, implements, supports and maintains Epic revenue cycle applications, solutions and business processes to meet operational and technical requirements. Obtains and maintains in depth knowledge of software functionality and acquires as well as utilizes knowledge of operational workflows to be implemented. Areas of responsibility may be H

Under the direction of the Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and on time. Maintain a safe and professional environment for applicants, clients, and employees, perform with confidence all aspects of an insurance exam, including specimen collect

Analyzes invoice with no adjudication status to facilitate timely reimbursement for 1 billion + annual billing of provider services. Reviews, researches, and corrects TES edits, eligibility and registration corrections. Ensures that claims meet billing guidelines for assigned carriers. Uses GE IDX ETM to ensure the claims status is changed to ensure successful resubmissio

of Position Serve as the key operational liaison with Provider Network Management and Finance responsible for the reconciliation, reprocessing/recoupment and provider communication for claim payment integrity challenges. Oversee contract review; ensure that contract provisions are in alignment with corporate goals. Develop and implement dashboards to monitor performance. D

Competitive Pay! Overflowing benefit package 33 Paid days off 1st year! Responsible for ensuring optimal and timely reimbursement by maintaining accurate client eligibility information and resolving errors before claims are filed. Work closely with the COPES clinicians to improve processes, efficiencies, and productivity. Generate and complete assigned reports, adhering t

The Senior Claims Manager will oversee and ensure the efficiency and accuracy of healthcare claims operations. This position oversees the claims inventory by setting, evaluating, and monitoring the claims inventory and examiner production metrics and is responsible for timely and precise benefit determinations for claims, while upholding exceptional service standards for

Assist in end to end provider claims and help enhance call quality Coach, provide feedback and guide others Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers, and practice managers Help implement train

Job Number R0198593 Cost Estimator, Lead The Opportunity The right mixture of great ideas and funding can create change. In a complex organization, allocating funding to where it can be most effective can be challenging. That's why we need you, an experienced financial analyst who can show a team how to navigate the requirements, policies, and regulations that govern fund

The Charge Data Specialist is responsible to complete the services of charges posted for areas of Children's National Health System. The Charge Data Specialist provides financial analysis, guidance, and advice to management consistent with standard charge posting practices. The Charge Data Specialist will ensure accurate and timely charge capture and quality assurance pro

JOB ANNOUNCEMENT CLAIMS MANAGER Department of Finance Risk Management Number of Positions 1 (additional vacancies possible pending budget approval) Under direction, investigates and evaluates claims against the City of Chicago and provides support on litigation matters involving alleged damage to private property. ESSENTIAL DUTIES Oversees the claims management process fo

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en