Care Manager: Long-Term Care Eligibility & Claims
illumifin Corporation
LTCG in Minnesota is seeking a Claims Eligibility Analyst to review medical records and conduct phone assessments to determine initial and ongoing eligibility for claimant benefits. The role involves evaluating provider eligibility using licensing data and state regulations, and communicating findings to clients and internal teams. Successful candidates will participate in case conferences, adhere to quality metrics, and support modifications to care plans as needed. #J-18808-Ljbffr illumifin Corporation
$60k
...'s leading administrator of long term care insurance services is looking... ...for the insurance industry, managing over 1.3 million long-term... ...ongoing claimant and provider eligibility. RESPONSIBILITIES 1.... ...written, all aspects of the claim benefit determination process...ClaimsFull timeContract workWork experience placementWork at officeRemote work$54.1k - $155.54k
...by passionate colleagues who care deeply, innovate with purpose... ...Holding, Inc (AHH) is a medical management company that is a division... ...multidisciplinary focus to benefit overall claim management. Using a... ...This full‑time position is eligible for a comprehensive benefits...ClaimsHourly payFull timeLocal areaRemote workWork from homeFlexible hours- ...career with us, experience our caring culture, and enjoy work-life... ...& Insurance RN Field Case Manager We are growing all across... ...from. ~ Tuition reimbursement eligible. ~401K plan that matches 50... ...the world's leading risk and claims administration partner, which...ClaimsFull timeWork at officeRemote workWork from homeRelocation packageFlexible hours
$19 - $27 per hour
...Specialist with hands-on experience in claim submission, denial management, payment posting, accounts... ...logs, and checking patient insurance eligibility. Processing of claims for reimbursement... ...compassionate, state of the art dermatologic care to each patient with an emphasis on...ClaimsHourly payLive inWork at officeRemote work$23.32 - $25.65 per hour
...medications and services provided to long-term care facilities and their... ..., and processes insurance claims; resolves discrepancies, rejections... ...reports to the Billing Manager. Radius Living Rx is a... ...Benefits Full-time benefits-eligible employment begins at a...ClaimsHourly payDaily paidFull timeTemporary workPart time$74.5k - $104.3k
...people’s lives. As a Nurse Case Manager, you will serve as a medical... ...manage workers’ compensation claims. Working primarily by phone,... ..., including assessment, care planning, and coordination of... .... Free life insurance, short-term & long-term disability coverage. Incentive...ClaimsTemporary workWork at officeLocal areaRemote workFlexible hours$24 - $32 per hour
...organization provides specialized eye care and surgical services with a... ...cycle by ensuring medical claims are processed accurately and on... ...promptly. Review insurance eligibility, benefits, and coverage requirements. Obtain and manage prior authorizations as required...ClaimsPermanent employmentContract workWork at office$23 - $26 per hour
...Representative! We are a dedicated and caring organization known for our... ...as requiredChecking benefits and eligibility for DME coveragePreparing and reviewing claims using billing softwareChecking insurance... ...time offpaid holidayslong-term disabilityshort-term disabilityfree...ClaimsFull timeContract workLocal area- ...spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our... ...thrive. We are seeking a full-time Nurse Case Manager to cover the Minneapolis / St. Paul area.... ...Case Manager works with all parties to the claim including: the injured person, the claim’...ClaimsFull timeInternship
$29 - $46.5 per hour
...with a commitment to quality care and service in a Christian environment... ...supports Skilled Nursing/Long Term Care facilities in Minnesota... ...data into Customer Referral Management (CRM) and the electronic... ...time employees. Depending on eligibility, a variety of benefits include...Full timePart timeWork experience placementRemote workMonday to FridayShift workWeekend workDay shift$37 per hour
Senior Care Specialist (Registered Nurse) Work From... ...offerings for clinical, case management, member engagement,... ..., payment integrity, claims cost containment, and analytics... .... Daily Pay: Eligible employees may have access... ...to applicable program terms. Join a Team with Purpose...ClaimsHourly payDaily paidSeasonal workRemote workWork from home$37 - $40 per hour
...exceptional, individualized care leads to lasting... ...Responsible with medication management including education,... ...(EyeMed) Short-term and long-term disability insurance... ...first whole pay period. Eligible employees enjoy seven... ...3 weeks ago Clinical Claims Review RN - National Remote...ClaimsHourly payFull timeTemporary workRemote workRelocation packageNight shiftWeekend workAfternoon shift$63k - $92.1k
...Job Duties SUMMARY: The Nurse Case Manager (NCM) is responsible for applying medical... ...knowledge in reviewing workers' compensation claims to assess, evaluate, plan, implement and... ..., discusses and finalizes alternative care and return to work programs with permanency...ClaimsFull timeContract workCasual workWork at officeShift work- ...as a medical resource and educator to assist with the management of workers' compensation claims. Most work is done telephonically. You will work collaboratively... .... Coordinates discharge planning, DME, and home health care needs.Makes recommendations to the claims rep resources...ClaimsRemote work
- ...accurate patient account records to support timely reimbursement and cash flow. You will process and submit bills, enter charges and payments, follow up with insurers on submitted claims, perform electronic billing, post cash receipts, and balance AR. #J-18808-LjbffrClaimsWork at office
- ...programs here at Aetna. We care about each other, our customers... ...’ Compensation Field Case Management team. This opportunity offers... ..., including injured workers, claims adjusters, attorneys, employers... ...scanner all in one. Benefit eligibility may vary by position. Click here...ClaimsFull timeLocal areaRemote workWork from homeMonday to FridayFlexible hoursShift work
- ...Medical Records SpecialistMedlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients’...ClaimsFull timeWork experience placementWork at office
- ...regulatory knowledge, and strong attention to detail to ensure accurate billing and compliance. Collaboration with staff and time management are essential. Experience across coding levels I-III and commitment to maintaining credentials are required. #J-18808-Ljbffr...Claims
- WPS, a health solutions company, is hiring an Appeals Nurse to review medical records and claims for first-level appeal cases, ensuring medical necessity and adherence to Medicare guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations...ClaimsRemote job
- .... is seeking an experienced Medical Collections professional to manage outstanding accounts receivable for Commercial and Medicaid payers... ...follow-up, denial resolution, and accurate resubmission of claims in a fast-paced healthcare environment. Ideal candidates will have...Claims
$23.98 - $34.69 per hour
Working Title: Provider Eligibility and Compliance Specialist Job Class... ...and abuse. Minnesota Health Care Programs (MHCP) enrolls more... ...PEC is charged with managing and maintaining the data in the... ...Experience with MPSE, MMIS or other claims processing subsystems...ClaimsHourly payFull timeTemporary workPart timeLive inWork at officeLocal areaRemote workMonday to FridayShift workDay shift$41.58 - $60.1 per hour
Telework Eligible: Yes Job ID: 97987 Location: St. Paul... ...Services Dept / DHS Manager Division/Unit: DHS-Central... ...& Continuity of Care Section within the Behavioral... ...integrity operations, claims review governance, and... ...event of death Short-term and long-term disability...ClaimsHourly payPermanent employmentFull timeTemporary workPart timeLive inWork at officeLocal areaRemote workMonday to FridayFlexible hoursShift workDay shift- ...medication administration training. Reporting to the Executive Director of Nursing, the RN will also coordinate intakes and manage care plans. Eligible candidates must be licensed in Minnesota, with a minimum of two years free from chemical use problems. Strong computer...
$38.83 - $55.93 per hour
Telework Eligible: Yes Job ID: 98242 Location: St.... ...Unit/Union: 216 - Middle Management Association/MMA FLSA... ...of the continuity of care and complex transition... ...prepayment review, focused claims review, or provider... ...event of death Short-term and long-term disability...ClaimsHourly payFull timeContract workTemporary workPart timeLive inWork at officeLocal areaRemote workMonday to FridayFlexible hoursShift workDay shift- ...Collections Representative for a full-time, on-site role. The position runs Mon-Fri, 8:30 am - 5 pm, and focuses on patient billing, claims processing, and customer service. Ideal candidates have Medicare/DME billing experience and a high school diploma; an AA degree is...ClaimsFull timeLocal area
$70k - $92.68k
...evaluate insurance applications, review claims, and make decisions on policy approvals.... ...specified but are likely to be offered to eligible employees. The role is ideal for... ...proficiency in Microsoft Office Suite, project management tools, and familiarity with industry-...ClaimsFull timeWork at officeRemote work- ...are committed to providing high-quality care to its residents and is always looking to... .... You will be responsible for submitting claims to all insurance carriers, and posting cash... ...reviews with the business office manager. The ideal candidate will have experience...ClaimsWork experience placementWork at officeLocal areaMonday to Friday
$75k - $90k
...RN Case Manager – Hospice Pay: $75,000 – $90,000 per year Job... ..., dignity, and compassionate care in the final chapter of life.... ...and personal use*Based on eligibility ~ Medical, dental, and vision... ...insurance ~ Life insurance, Long term/Short term disability...Full timeTemporary workMonday to Friday- ...Monarch Healthcare Management Benefits Include: ~ UKG Wallet... ...growing company! LPN Care Coordinator Position Summary... ...; must meet employment eligibility per MN Department of Human... ...is changing the way short-term rehabilitation and long-term care are delivered. Our...Temporary work
$70k - $78k
...grow your career with us, experience our caring culture, and enjoy work-life balance. Here... ...Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering... ...and builds relationships with the claims' examiner, client, injured worker, attorney...ClaimsFull timeWork experience placementRemote workFlexible hours
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