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This position is responsible for ensuring institutional compliance with the Virginia Department of Behavioral health and Developmental Services, Virginia Medicaid Services, Tricare and Joint Commission. This position is tasked with ongoing compliance audits of current medical records. Key Responsibilities The Medicaid Specialist is tasked with auditing all open charts con

Requires daily contact with customers, attorneys, bank officers, and insurance agents by phone and/or letters Order flood determinations for new commercial loans in process Reviews all commercial and mortgage new loans for proper hazard/flood insurance coverage/documentation Tracks flood insurance policies for lapses in coverage Prepares and sends required regulatory lett

Receive and process electronic eligibility files for new and/or existing customers Review enrollment/eligibility files to identify unclear, missing, or invalid data Compare submitted enrollment/eligibility information to relevant internal systems Communicate with stakeholders to obtain new information and/or clarify concerns Submit and/or review new electronic eligibility

A Customer Service Professional position requiring creativity, empathy, interpersonal skills and a strong desire to assist customers. Provides prompt claim investigation, evaluation and settlement or denial of claims with moderate to highly complex exposures. Provides empathy and understanding to customers that may be upset or frustrated. Authorizes payments in accordance

Analyze and develop solutions addressing customer Electronic Data Interchange (EDI) and punchout catalog needs. Qualify, develop and implement EDI and punchout catalog partnerships with Uline's customers. Serve as liaison between Uline's eCommerce, Sales and IT teams and our customers. Assist with testing new EDI and punchout catalog implementations and troubleshooting is

Are you looking for an exciting opportunity? We currently have a full time opening for a Remote Payor Contracts Administrator . If you are looking for a fast paced environment where you can make a difference every day, then this is the opportunity for you! The right person to join our team is... This position requires confidence, independent action, initiative, a sense of

Promotes excellent customer experience with individuals, families, and providers. Using their own personal experience, engages with individuals served to establish a collaborative relationship by conveying respect for the person, acceptance, and a non judgmental attitude. Advocates for individuals in communicating their preferences and needs while coordinating outpatient

Under the direct supervision of the Claims Processing Supervisor and the general direction of the Manager, Claims Production, this position is responsible for the accurate review, entry and processing of all claims received for payment by AAH. Principal responsibilities include Research claims for completion and appropriateness. Review and handle rejected claims as necess

REACH YOUR POTENTIAL | COLLABORATE WITH AMAZING PEOPLE | MAKE CHANGE HAPPEN Do you have the skills, passion, and commitment to transform our clients for the better? Are you ready to be a changemaker? If so, join us. North Highland is the world's leading change and transformation consultancy. Simply put, we make change happen like no one else. And we're on the hunt for a n

Promote the company's product portfolio and provide service assistance to consumers. Respond to consumer inquiries through inbound calls and internet inquiries. Deliver prepared sales scripts to educate, inform and provide solutions to potential customers. Describe solutions for individual sales situations. Communicate with consumers regularly regarding product informatio

We're looking for an Operations Analyst to serve as a business analyst for Westfield Specialty Claims. In this role, you'll assist in creating and refining business and functional requirements for claims processing and administration, as well as third party solutions and reporting integrations. You'll need to plan, organize, and prioritize your workload to meet multiple t

Insurance Coordinator ID 2024 7863 Job Location Location US MA Boston Type Regular Full Time Category/Department Risk Management Overview Suffolk is a national enterprise that builds, innovates and invests. Suffolk is an end to end business that provides value throughout the entire project lifecycle by leveraging its core construction management services with vertical ser

Manage and cultivate relationships with new and existing clients, providing detailed project management to coordinate and execute campaign deliverables successfully. Handle key strategic campaigns and engage in effective communication with key stakeholders. Generate and maintain campaign analysis reports using internal tools to update clients on the status of their progra

Maximize cash collections and minimize bad debt, while maintaining the integrity of each patient's account. Provide full charge responsibility for an assigned group of patient accounts to include third party billing, insurance follow up, reconciliation of account, and processing all applicable overpayments. Maintain knowledge of managed care contracts, Medicare/ Medicaid