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Responsible for responding to customer inquiries. Inquiries may be non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description 45% Ensures effective custome
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Reimbursement Specialist, Follow Up and Appeals 480 Wildwood Forest Dr, Spring, TX 77380, USA Full time Company Description Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics. Its Guardant Health Oncology Platform is designed to leverage its capabilities in technology,
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Job Title Provider Network File Technician (Health Insurance Provider/claims experience preferred) Job ID 6126 Location Phoenix Full/Part Time Full Time Favorite Job Regular/Temporary Regular Introduction Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not for profit health insurance company headquartered in Phoenix. Founded in 1939, the company
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The primary function of this position is to process medical claims to completion, ensuring proper payment in accordance with the benefit plan reference and guidelines. Job Duties & Responsiblities Interpreting coding and understanding medical terminology in relation to diagnosis and procedures Analyzes and answers inquiries regarding payment, co pay or deductible amounts, and/or reason for denial.
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Acara Solutions is looking for Medical Claims Auditor for our Client located in Irving, TX We are seeking a talented individual for a Medical Claims Auditor I who performs research analytics to support our recovery audit line of business. Assists in the development and implementation of new data mining and audit/review methodologies for identifying healthcare overpayments and underpayments to prov
Posted 1 day ago
This position reports directly to the General Counsel of Prosegur Security USA. The essential functions will be accomplished by working closely with key functional leaders within each organization and completing tasks within the deadlines provided. This position offers growth opportunity, based upon exceeding expectations. Essential Functions Assist with first notice of loss reporting to insuranc
Posted 1 day ago
Claim Examiner Workers Compensation Requisition ID 2020 11008 Job Locations US TX Dallas Position Type Regular Full Time Category Claims Business Unit Broadspire Excellence In Everything We Touch Position Summary Investigate, evaluate, negotiate, and settle moderate difficulty type claims; takes appropriate action to achieve results that have a positive impact on profitability. Settle claims fo
Posted 1 day ago
Claims Triage Agent Requisition ID 2020 11093 Job Locations US PA Allentown Position Type Regular Full Time Category Claims Business Unit Crawford Claims Solutions Excellence In Everything We Touch Position Summary Provides the critical role of claims triage by leveraging various tools and applications to accurately assign the correct product channel and end service providing resource to a vari
Posted 1 day ago
•Meets, or exceeds, established invoicing and recovery goals. •Completion of OI prime, Medicare and Post term investigations, as assigned, to achieve annual invoicing goals as well as established monthly reversal invoicing goals and completing the required minimum number of investigations per month. •Reviews audits/claims for other types of audits as developed by the Company. •
Posted 1 day ago
Claim Examiner Liability Requisition ID 2020 11118 Job Locations US TX Dallas Position Type Regular Full Time Category Claims Business Unit Broadspire Excellence In Everything We Touch Position Summary Investigate, evaluate, negotiate, and settle moderate difficulty type claims; takes appropriate action to achieve results that have a positive impact on profitability. Settle claims for assigned
Posted 1 day ago
Medica
- Minnetonka, MN
Medica's Claims Processors are responsible for the efficient and accurate processing of medical professional, institutional, dental, vision, and pharmacy claims. Our Claims Processors work to examine, process, and investigate claims in accordance with established contractual agreements and benefit plan designs. Minimum Qualifications High School Degree or equivalent combination of education and wo
Posted 1 day ago
of Responsibilities Handle moderate to complex casualty claims with minimal supervision and guidance from the manager. Utilize current Claims technology. Research and formulate a basis on which coverage decisions will be made, conduct thorough investigations, evaluate damages and liability. Negotiate settlements with insureds, claimants and attorneys. Responsibilities also include active file mana
Posted 4 days ago
Reimbursement Specialist, Follow Up and Appeals 505 Penobscot Dr, Redwood City, CA 94063, USA Full time Company Description Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics. Its Guardant Health Oncology Platform is designed to leverage its capabilities in technology,
Posted Today
Claim Examiner Liability Requisition ID 2020 10995 Job Locations US TX Dallas Position Type Regular Full Time Category Claims Business Unit Broadspire Excellence In Everything We Touch Position Summary Investigate, evaluate, negotiate, and settle moderate difficulty type claims; takes appropriate action to achieve results that have a positive impact on profitability. Settle claims for assigned
Posted 4 days ago
Reimbursement Specialist, Payment Posting (Temporary) 505 Penobscot Dr, Redwood City, CA 94063, USA Contract Company Description Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics. Its Guardant Health Oncology Platform is designed to leverage its capabilities in technol
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