Perform duties necessary to ensure the proper interpretation, processing, recording, approval and payment of inpatient and outpatient medical claims. Accurately reviews information for processing claims into a computerized system in accordance with the primary payer specifications and billing guidelines. Monument Health offers competitive wages and benefits on qualifying

Maintains expert level knowledge about industry; utilizes to manage pay models of complicated patient care plans and facilitates exceptional patient experiences as aligned with organizational values and mission. Acts as subject matter expert and guide to broad employee base, particularly providers, to educate and communicate on requirements, processes and adjustments need

Summary Under immediate supervision, performs eligibility related paraprofessional work of routine difficulty; and performs related work as required. Distinguishing Features An employee in this class assists Eligibility Counselors in case management activities and learns the rules and regulations necessary to determine eligibility for monetary benefits and social services

1. Elicits data and reporting requirements from hospital leadership, clinicians, and other staff, using interviews, document analysis, requirements workshops, site visits, use cases, scenarios, data analysis, task, and workflow analysis. 2. Queries and analyzes data from hospital systems such as our electronic medical record system (Epic), enterprise data warehouse (EDW),

Old Republic Surety Company (ORSC) is currently seeking a Customer Service Representative Agency Support to join its Agency Services Team in Brookfield, WI . ORSC ranks among the nation's top underwriters of contractors' performance and payment bonds, miscellaneous surety, and commercial fidelity, offering thousands of types of bonds. We are growing across the cou

Account Servicing Responds to service requests and proactively identified service needs. Manages new and existing insurance customer activities including policy check in, renewals, cancellations, endorsements, and initial claim activity. Performs data entry, processing, and risk analysis at an advanced level. Ensures accuracy and compliance with all rules and regulations.

Reporting directly to the Finance Department, the successful candidate will be responsible for coordinating insurance activities, analyzing insurance data, ensuring compliance with regulations, and fostering effective communication between internal and external stakeholders. This role will report directly to the Controller and will interact with third party insurance brok

JOB TITLE Insurance Verification Specialist GENERAL SUMMARY OF DUTIES Ensures all records are maintained in absolute integrity and in compliance with applicable regulations and requirements. Responsible for obtaining required referrals and authorizations and verifying patient insurance benefits. REQUIREMENTS 1 2 years experience in healthcare insurance billing, verificati

Putting People First in Pharmacy Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. W

The Producer is responsible for prospecting, soliciting and selling new commercial accounts. Continuing to counsel and market to existing clients professionally is another essential function of the position. Specific sales goals and service responsibilities are determined during yearly planning process for this position. Meets service and sales standards of volume with ti

At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees. This position is required to work in office, downtown Des Moines Processes written correspondence in response

Job Location Smithfield, RI Smithfield, RI Position Type Full Time Education Level Associates Degree   Travel Percentage Frequent Job Shift Daytime Job Category Some Experience Description This position is responsible for processing provider application for network entry and reappointment, including primary source verification of providers credentials according to Pla

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary This position will work from the Ri

Conducts moderate to complex subrogation investigations, evaluations, and communications to determine liability and recovery potential when third party responsibility has been identified. Determines recovery payments in accordance with assigned authority limit. Handles and/or assigns collection efforts to outside vendors such as attorney or collection agencies as appropria

EXCELLENT LOCAL OPPORTUNITY!