Average salary: $155,649 /yearly
More statsSearch Results: 18 vacancies
...in Project Management preferred.
Excellent time management skills.
Outstanding communication skills.
Knowledge of Claim adjudication process (Professional Institutional).
Fee schedule knowledge.
Diagnosis and procedures codes knowledge preferred....
Suggested
Hourly pay
Holiday work
Full time
Casual work
Relocation bonus
Flexible hours
...Job Description
Position Summary:
Responsible for entering encounter data onto the claims adjudication system. In addition, and/or data enter encounter information onto the HMO system(s).
Essential Duties and Responsibilities include the following:
Responsible...
Suggested
Hourly pay
Holiday work
Full time
Casual work
Immediate start
Relocation bonus
Flexible hours
...professional audits, complex audits on individual or random, training and focused claims to identify exceptions to established claims adjudication requirements for claims processing, payment and procedural accuracy. In addition, this position is responsible to assist with...
Suggested
Hourly pay
Holiday work
Full time
Traineeship
Casual work
Immediate start
Remote job
Relocation bonus
Flexible hours
...assigned product group.
Recommend, investigate, and document new product opportunities.
Coordinate with SIOP Manager/Process in adjudicating and prioritizing demand and Engineering leadership to ensure resource supply is adequate to meet supply plan.
Champion new products...
Suggested
Holiday work
Permanent employment
Temporary work
Worldwide
...calculations including basic mathematical calculations (e.g., convertingmilligrams)May resolve issues of denials identified through adjudication, and follow-up claims in Point ofSale (POS)
Maintains current knowledge of Medicaid claim regulations and processes
May produce...
Suggested
Weekend work
Monday to Friday
...functions to ensure health plan and regulatory compliance.
Education and Experience Required:
High School Diploma and 3 years adjudication experience in a managed care setting
Knowledge of CPT-4, HCPCS, Hospital Revenue, and ICD-9 coding
Knowledge of HMO, DHS,...
Suggested
Hourly pay
...etc. Submits required Utilization Management (UM) reports to the health plans in a timely fashion. Will coordinate with the Claims Adjudicator and Case Managers relating to patients referrals, claims or case management. Will coordinate with patients, Managed Care Dept.,...
Suggested
Hourly pay
Full time
...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...
Suggested
Full time
Contract work
Local area
Shift work
...Systems, Systems Analysis, and Design
Current/active U.S Government issued DoD Secret Clearance; clearance must have been issued/adjudicated in the past five (5) years
Experience as an AFSIM developer/analyst, including making and validating movers, creating...
Suggested
Work alone
Relocation package
Shift work
...employment screening (criminal background, drug testing, and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job...
Suggested
Local area
Gangs
...Citizen or National.
Males born after 12-31-59 must be registered for Selective Service or exempt.
Subject to satisfactory adjudication of background investigation and/or fingerprint check.
Successful completion of one-year probationary period, unless...
Suggested
Remote job
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Second job
Relocation
Gangs
Monday to Friday
...Citizen or National.
Males born after 12-31-59 must be registered for Selective Service or exempt.
Subject to satisfactory adjudication of background investigation and/or fingerprint check.
Successful completion of one-year probationary period, unless...
Suggested
Remote job
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Second job
Relocation
Gangs
Monday to Friday
Summary Accurate review, input and adjudication of provider specialty claims, including UB04s, in accordance with outside regulations, internal production standards and the contractual obligations. Knowledge of medical terminology necessary. Strong knowledge of Commercial...
Suggested
Hourly pay
...review all incoming claims to verify if required fields are populated.
Process claims information into the computerized claims adjudication system.
Ability to process claims in the allotted time based on departmental policies and procedures.
Maintain all required documentation...
Suggested
Hourly pay
Flexible hours
...can bring your big ideas to help solve problems for some of the world's best brands?
Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
Deliver innovative customer-facing solutions to clients who represent...
Suggested
Flexible hours
...operates the ‘California Conditional Release Program,’ a specialized intensive community supervision and treatment program for people adjudicated as “Sexually Violent Predators” and court-ordered to transition from in secure residential treatment in the community.
Liberty...
Hourly pay
Part time
Work experience placement
Immediate start
Remote job
Work from home
Home office
Trial period
Flexible hours
Shift work
Monday to Friday
...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
...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.
ESSENTIAL FUNCTIONS...
Contract work
Local area
Flexible hours
