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

Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist providers and members with basic inquiries about claims, authorizations, benefits, and other issues Fostering and maintaining proactive, positive relations throughout the provider network by communicating with provider offices through face to face visits, emails, telephone

At Children's Wisconsin, we believe kids deserve the best. Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family res

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 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

Come work at a place where we take pride in creating a workplace environment that values hard work, commitment, and growth . Job Description Education High School diploma or equivalent required Associate's degree in Business Administration or relevant field of study preferred Insurance adjuster license required Work Experiences 4+ years' claims experience working with wor

Incumbent is responsible for obtaining all necessary authorizations in accordance with established guidelines. Verifies eligibility, obtains benefit information, and generates letters for authorizations. Responds to Member Services and Call Center inquiries and resolves any identified authorization issues which arise. Total Compensation In addition to the salary range lis

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

Investigate all non standard claim problems (25%) Investigates for COB and determine the primary payer (25%) Investigate and process adjustment requests (25%) Adjust claim payments resulting from duplicate payments, incorrect payee, etc. Recover expended funds for managed care plans System documentation of investigation results Training of Coordination of Benefits claim p

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

Accountable for a full range of provider relations including engagement with and development of prospective providers Design and implement strategies to increase the membership of providers in the network Create and execute a marketing plan to build and nurture provider network Identify needs in provider network, incorporating potential gaps related to composition, servic

3000 DaVita Way,Deland,Florida,32724 2039,United States of America Job Description GENERAL PURPOSE OF THE JOB The Specialist I, Denials (Lab) is responsible for the review and resolution of denied claims due to benefit issues, verifying applicable insurance coverage for multiple states, and determining correct coordination of benefits information. Applies the knowledge and

JOB DESCRIPTION Position Type Full time Type Of Hire Experienced (relevant combo of work and education) Travel Percentage 1 5% FIS is a leading provider of technology solutions for merchants, banks and capital markets firms globally. FIS stays ahead of how the world is evolving to power businesses in today's fast changing competitive landscape and help our clients run, gr

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

Universal Health Services (UHS), one of the nation's largest and most respected providers of hospital and healthcare services, one of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. In 2024, UHS was recognized By Newsweek and Plant A Insigh