Claims Representative THERAPY, Providence Mount Carmel Hospital Colville, WA Under the supervision of the Rehab Services Manager or Assistant Manager, the Insurance Coordinator provides support to the department and its patients concerning insurance coordination and authorization. Demonstrates behavior practices that reflect the philosophy and mission of our sponsors, Pro

The Insurance Follow Up Specialist contributes to the financial viability of the organization by assuring that accounts have been properly billed and reimbursed. Responsibilities include contacting the appropriate insurance company to secure and expedite payments through the follow up and appeals resolution processes, and acting as a functional leader or reference source.

Job Duties The duties of this position include filing dental insurance claims and pre treatment estimates for privately insured patients; obtaining and providing the clinical documentation necessary for claims processing, i.e. x rays, chart notes and letters of necessity; investigating certain denied claims, following up on those investigations and submitting claims appea

Gundersen Health System is looking for an experienced individual to help our Professional Coding and Reimbursement Team continue to succeed and advance! The Supervisor works under the direction of the Director to effectively accomplish the duties and responsibilities outlined in Gundersen Health System’s Supervisor Job Charter. Supervises the daily operations of the

Serve as single point of contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum's internal processes and priorities, and other Optum initiatives, as applicable Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to dev

3000 DaVita Way,Deland,Florida,32724 2039,United States of America GENERAL PURPOSE OF THE JOB The Specialist I, Collections (Lab) is to secure maximum reimbursement on all claims based on payer terms. Applies the knowledge and skills to complete a wide range of tasks at a level which meets department standards and ensures goals and objectives are achieved. Ensures claim ad

Responsible for processing medical claims. Resolves complex, difficult or non routine claims requiring special handling in accordance with established policy guidelines. Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit determination for reinsurance qualification. Handles complex, difficult or non routine incoming and o

The essential duties and responsibilities (including but not limited to) Directs the daily operation of the revenue cycle liaison department to ensure client satisfaction. Ensures that daily, weekly, and monthly liaison functions are performed. Demonstrates thorough understanding of and oversees all aspects of liaison functions, to include monitoring and interpreting reve

The Reimbursement Specialist improves revenue collection pertaining to high cost medications that require prior authorization. This job will initiate, follow up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically. The Reimbursement Specialist carries out benefit investigation and coordinates Patient Assistance Pro

Additional Information The Member Advocate will serve as a Liaison between the Members and Cook Children's Health Plan (CCHP). The Member Advocate will help Members and their Legally Authorized Representatives (LARs) navigate through the complexities of the healthcare system. The Member Advocate will guide and educate Members on their benefits, Member Rights & Responsibil

The Special Investigations Unit is responsible for investigating and resolving high complexity healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. This position researches, gathers, and analyzes claims data, medical records, corporate policy, state/federal policy, and practice standards to identify trends, patterns, aberrancies, and o

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

3000 DaVita Way,Deland,Florida,32724 2039,United States of America GENERAL PURPOSE OF THE JOB The Specialist I, Cash Posting (Lab) knows and performs all essentials duties and responsibilities as outlined below. Understands the job and applies knowledge and skills to complete a wide range of tasks at a level which meets department standards and ensures goals and objectives

Review claims for completeness and accuracy to determine if additional information and/or supporting documentation is required Research and respond to inquiries from members and internal business units Process GAP claims and make decisions within established guidelines and policies Provide claim and contractual information to appropriate internal and external parties Rese

What You Can Expect Make a living while you make a difference at Trilogy Health Services a senior living provider with the continuous goal of being the Best Healthcare Company in The Midwest. Location Trilogy Health Services Text One Of Our Recruiters John (502) 829 7857 What We're Looking For The Total Rewards Intern works as an apprentice under the direction of the Dire