Review assigned accounts by contacting Medicare to ensure timely resolution of accounts. Create updates and document information relating to the financial status of accounts in the hospital billing systems. Contact patients and/or other third party representatives to secure additional information pertaining to reimbursement of accounts. Process rejected/adjusted claims th

Manages Maryland and District of Columbia member and provider medical appeals, Maryland complaints and grievances. Responsible for member advocate functions. Interacts directly with members, staff, physicians, and others on the telephone to resolve issues. Acts as a resource and documents all information as it relates to medical appeals/complaints and grievances. Assists w

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

The Claims Supervisor is responsible for the daily oversight of claims processes including but not limited to the inquiry and resolution process, adjudication process, user acceptance testing and quality assurance, training, and reporting. In addition, the position assists the claims manager with claims related queue management (i.e. claims, inquiries, refunds, adjudicati

. Work Schedule and Additional Information Full time employment Work hours are 8 00 AM to 4 00 PM, Monday Friday, with 30 minute lunch. Telework You may have the opportunity to work from home (telework) part time. In order to telework, you must have a securely configured high speed internet connection and work from an approved location inside Pennsylvania. If you are unabl

The Claims User Acceptance Tester (UAT) will be responsible for validating whether all the business requirements have been fulfilled before releasing the actual product to production. The individual will perform positive and negative testing to identify and ensure any defects found are corrected prior to implementation. The Claims UAT will develop and follow a test plan w

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Claims Insurance Manager Medical Profe

As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing s

Responsible for ensuring optimal and timely reimbursement by maintaining accurate client eligibility information, resolving errors before claims are filed, and following up on claims, denials, payer correspondence, and authorizations. Work closely with the Reimbursement Supervisor to improve processes, efficiencies, and productivity. Requirements Requires High School dipl

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Competitive Pay! Overflowing benefit package 33 Paid days off 1st year! Responsible for ensuring optimal and timely reimbursement by maintaining accurate client eligibility information, resolving errors before claims are filed, and following up on claims, denials, payer correspondence, and authorizations. Work closely with the Supervisor of Reimbursement Billing to improv

Provides technical expertise for assigned product line(s) in the handling of complex, contestable, sensitive and large benefit amount claims. Primary Duties & Responsibilities Responsible for providing technical expertise to applicable product line benefits division in the handling of complex, contestable, sensitive and large benefit amount claims. This includes responsib

Property/Asset Specialist (Ashburn, VA) Job Locations US VA Ashburn Job ID 2024 11021 # of Openings 1 Category Supply Chain Overview LMI seeks a Property/Asset Specialist to support a federal program management office in the National Capital Region (Ashburn, VA). Join our team of collaborative self starters focused on delivering practical and efficient solutions to help o

This position supports the Risk Management Department in directing the worldwide Risk Management Property and Casualty insurance programs for asset protection and strategic advantage. Essential Duties and Responsibilities Manage process and performance to obtain optimal outcomes involving a claims portfolio of approximately 10 million of annual cash outflows, and other as

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the