...demonstrating proficiency with the XIFIN billing system to ensure all functionalities are utilized for the most efficient processing and adjudication of claims. Responsible for identifying and reporting collection trends and/or issues resulting in delayed claims processing....
Suggested
Permanent employment
Shift work
...California, Florida, and Missouri. From starting off selling service contracts, we have diversified into an administrative company adjudicating its own claims from its Texas office and currently in process of owning all of its policies through its reinsurance company that...
Suggested
Shift work
Weekend work
...and accident claims
Ability to interpret Plan Documents or Summary Plan Descriptions (SPD) for the purpose of accurate claim adjudication and/or benefit determination
Basic knowledge of medical terminology. Familiar with UB-04 and HCFA 1500 forms (837/5010 format...
Suggested
Contract work
Local area
Remote job
...Technician I is primarily responsible for assisting the pharmacist in obtaining all the necessary information for dispensing and adjudicating a medication correctly. The Pharmacy Technician I’s main objective is to answer phone calls and contact the doctors and patients...
Suggested
Holiday work
Temporary work
Flexible hours
Monday to Friday
...to status, complaints, eligibility, benefits, etc.
2. Working knowledge of CPT/HCPC and ICD-9/ICD-10 codes and guidelines.
3. Adjudicate routine medical claims and all associated tasks in accordance with the Plan, regulatory and contractual guidelines.
4. Maintain...
Suggested
Holiday work
Local area
...demonstrating proficiency with the XIFIN billing system to ensure all functionalities are utilized for the most efficient processing and adjudication of claims. Responsible for identifying and reporting collection trends and/or issues resulting in delayed claims processing....
Suggested
Casual work
Shift work
...broker relations by identifying and meeting customer needs.
Oversee all aspects of claims process, ensuring timely and accurate adjudication, driving improvements in efficiency and effectiveness which align with AmTrust’s goals and objectives.
Lead, manage and...
Suggested
Full time
Local area
Flexible hours
...relates to corporate (or similar) support and processing;
Exhibiting knowledgeable of pre-employment screening and process to adjudicate candidates, to include use of public record systems, social media searches and working with national, county or local courts & law...
Suggested
Remote job
Full time
Local area
H1b
...lots)
Knowledge of the California Vehicle Code.
Some knowledge in regards to impounding/releasing vehicles.
Knowledge of adjudication/citation appeals process. Basic knowledge of a hand-held, two-way radio system.
Basic knowledge hand-held ticket writer....
Suggested
Hourly pay
Local area
Outdoor
...day knowledge of permit types, parking privileges, enforcement practices, and campus layout. The incumbent will assist with the adjudication of first-level citation appeals, collect money from permit dispensers, assist with event parking activities, and enforce pedestrian...
Suggested
Hourly pay
Local area
Outdoor
Afternoon shift
...advanced, specialized expertise, the Academic Integrity & Student Conduct Specialist is responsible for independently investigating, adjudicating, and processing complex cases referred to the Office of Academic Integrity & Student Conduct (OAISC). Cases include, but are not...
Suggested
Contract work
Temporary work
Local area
Remote job
Afternoon shift
...analysis and monitors trends identified through the audit process. This individual will take the lead to ensure accurate and timely adjudication of claims, as well as identifying potential issues and recommending strategies for resolution. Apply claim and/or inquiry...
Suggested
...of capital structures to identify referrals.
+ Strong knowledge of portfolio management and related credit qualification and adjudication standards, policies, and procedures.
+ Strong interpersonal, sales, customer service, and negotiation skills.
+ Deep knowledge...
Suggested
Contract work
Temporary work
Part time
...by USCIS. Direct personnel in the conduct of systemic comprehensive reviews to determine fraud levels and vulnerabilities in the adjudications process, as well as addressing national security and public safety concerns. Coordinate efforts with Immigration and Customs...
Suggested
Full time
Part time
Local area
Immediate start
Remote job
Overseas
...benefit claims for our valued members. Your main responsibilities will include:
Your main responsibilities will include:
+ Adjudicating dental claims using an in-house system.
+ Maintaining a high levels of customer service with internal and external customers...
Suggested
Hourly pay
Permanent employment
Temporary work
Work experience placement
Local area
Remote job
Shift work
...per hour
Security Requirements : Moderate Risk (position sensitivity level 5): This position requires completion & favorable adjudication of a Moderate Risk Background Investigation (Tier 2) prior to appointment, unless waiver is obtained.
Physical Effort :...
Hourly pay
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Local area
Outdoor
Work alone
...subject to the completion of a favorable suitability or fitness determination, where reciprocity cannot be applied; unfavorably adjudicated background checks will be grounds for removal.
Selective Service Requirement: Males born after 12-31-59 must be registered or...
Holiday work
Permanent employment
Full time
Contract work
Temporary work
Part time
For contractors
Overseas
Trial period
Flexible hours
Weekend work
Afternoon shift
...within USCIS to strengthen national security and the integrity of the country's legal immigration system by closely aligning the adjudication of immigration benefits and services with the identification of potential threats to national security and/or public safety, the...
Remote job
Weekly pay
Permanent employment
Full time
Temporary work
Part time
For contractors
Local area
Immediate start
Overseas
Night shift
...bring your big ideas to help solve problems for some of the world's best brands?
Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
Deliver innovative customer-facing solutions to clients who...
Flexible hours
...calculations including basic mathematical calculations (e.g., converting milligrams)
May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS)
Maintains current knowledge of Medicaid claim regulations and processes
May...
Full time
Flexible hours
Shift work
Weekend work
...responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per diem, case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they relate to claims...
Full time
Contract work
Local area
Work from home
Shift work
...Auditing Department. This position will assist in managing, overseeing, and fulfilling requirements for all internal claims audits and adjudications for all product lines (Medicare, Commercial, and Medi-Cal) for all health plans to maintain timeliness and accuracy in...
Full time
Local area
Work from home
Shift work
...claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation...
Local area
Remote job
...training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
PRIMARY PURPOSE...
Flexible hours
...Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Monitor check run process for accuracy. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client...
Full time
Local area
Work from home
Shift work
...Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for FINThrive adjudication issues, and referral to refund unit on overpayments.
Perform research, makes determination of corrective actions, and takes...
Contract work
Relocation bonus
...required
Excellent verbal and written communication skills
Basic knowledge of government payor regulations, contracts and adjudication
Advanced analytical skills
Excellent Organizational skills
PHYSICAL REQUIREMENTS:
# Body Positions: Sitting and standing...
Work experience placement
Relocation bonus