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New! YesterdayProcess medical, supplemental, or dental claims by researching and validating documents, assessing eligibility, and analyzing benefit plans. Meet quality and productivity goals and collaborate with supervisors and trainers to improve processing techni..
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FeaturedNew! YesterdayCommunicate common problems/questions presented by callers to appropriate Subjects Matter Experts, to drive continuous improvement. Educate callers on self service resources available to them, and on their responsibilities with regard to their health...
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FeaturedNew! YesterdayAnswer a high volume of calls from patients or their representative, regarding patient bill balances, payment plans, credit card payments, patient pricing, re billing insurance companies and general customer concerns. Process adjustments, refunds...
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New! YesterdayThe Benefits Coding Analyst II maintains plan benefits, ensures compliance with guidelines, and coordinates benefit design documentation. Conducts research, codes policies, and assists with benefit development. Must have CPC certification and experien..
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New! YesterdayReview and resolve property damage claims, communicate with insured parties, work in a paperless environment, and negotiate fair settlements. Computer literacy and an adjuster license required. High school diploma and claims adjusting experience prefe..
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New! YesterdayManages workflow for audits and appeals, responds to queries, completes claim appeals, and ensures confidentiality of patient accounts. Experience with appeals and denials, medical claims, and excellent customer service skills required.
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New! YesterdayProcess dental claims efficiently with strong attention to detail. Follow standard operating procedures, navigate multiple computer applications, and deliver high-quality results independently. Collaborate with colleagues to meet productivity and...
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New! YesterdayMake accurate decisions on claims, provide timely disability claim decisions, superior customer service, administer claims for various group sizes, consult with legal, investigative and financial specialists.
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New! YesterdayManage E-discovery and ESI collections, manage litigation holds, collect and organize data to support corporate litigation, and act as a technical advisor for internal counsel. Locate the appropriate resources and experts to provide information...
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New! YesterdayIndependently review and analyze appeals related to cost containment programs. Review and analyze health care claims for accuracy. Consult with other entities for additional review.
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FeaturedNew! YesterdayReview and analyze hospital facility bills, research and identify adjustments for payment, ensure adherence to state and federal compliance policies, and maintain quality and production standards as determined by management.
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New! YesterdayDevelop a deep understanding of healthcare revenue cycle domain and claim submission process. Outline a roadmap for the claim submission squad prioritized around organizational goals. Perform discovery to identify impactful features.
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New! YesterdayProvide outstanding customer service in a call center environment. Respond to inquiries, provide detailed benefit quotes, educate members and providers, and research claims. Requires customer service experience. Pay range $17.91-$27.90.
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New! YesterdayAnalyze claims data, identify discrepancies, report errors to management. Communicate with stakeholders, develop reporting mechanisms, manage projects. Bachelor's degree and experience in medical insurance claims required.
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New! YesterdayAn entry-level HR position supporting the management of unemployment claims. Investigate, analyze, and respond to claims, appeal unfavorable decisions, attend virtual hearings, and contribute to best practices. Requires strong analytical and communica..
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New! 2 days agoA Data Entry Administrator is needed for a company in Edmonton. Responsibilities include verifying data, entering data accurately, and submitting warranty claims. Requirements include attention to detail and proficiency in MS Office and Vista Viewpoint.
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New! 2 days agoCommunicate with providers, analyze data, track errors, identify opportunities, contribute to performance improvement, and participate in special projects. Qualifications: high school diploma, customer service/claims processing experience, basic sprea..
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New! 2 days agoReview, scan, and key incoming appeals. Sort, prep, and scan appeals and relevant information. Support incoming faxes and create coversheets for responses. Assist team members and perform other assigned tasks.
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New! 2 days agoLead a team of Absence Management Case Managers, set objectives, communicate progress, ensure adherence to quality standards, resolve complex customer issues, and collaborate with internal cross-functional teams.
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New! 2 days agoFollow-up on billed claims, manage work queues, respond to patient inquiries, identify denial trends, pursue appeals, review processes, achieve team performance, analyze trends, and assist with training. Consistently reviews processes and recommends...
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FeaturedNew! 2 days agoActively participate in team huddles and meetings by way of sharing knowledge, requesting information, and recommending process improvements. Ensure assigned discharged and final billed accounts are not aging and are escalated timely.
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New! 2 days agoHire, develop, and mentor a team of associates responsible for investigating and settling property and casualty claims. Communicate and reinforce productivity standards, provide coaching and direction, and ensure complete and sound claim settlements.
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New! 2 days agoOversee a team of 15 people, provide direction to ensure clean claims are submitted, manage work queues, productivity, and quality. Must have professional billing experience and team management experience.
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New! 2 days agoActs as a liaison between Tier II providers and the health plan. Manages network performance, evaluates provider performance, and develops strategic plans for improvement. Facilitates trainings, orientations, and assists with claim resolution.
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New! 2 days agoUtilize claim management skills to investigate disputed claims, interpret plan language, and make accurate appeal determinations. Evaluate medical, financial, and other claim information in consultation with professionals to resolve disputes.
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New! 2 days agoAnalyze, investigate, and evaluate losses to determine coverage and claim disposition. Establish appropriate reserves and prepare comprehensive reports. Manage the litigation process and actively participate in mediations.
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New! 2 days agoLead by example, provide resolution on escalated customer inquiries, influence strategic improvement initiatives, support hiring and development of staff, demonstrate effective coaching, monitor call center performance.
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New! 2 days agoInvestigate and determine liability for property/casualty claims, arrange appraisals, and settle claims. Handle both 1st party and 3rd party claims under multiple policy types. Conduct on-site inspections, evaluate damages, and negotiate claims with i..
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New! 3 days agoInvestigate claims, determine policy coverage, negotiate settlements, and maintain accurate documentation. Strong customer service and organizational skills required. High school diploma or equivalent required; Bachelor's degree preferred.
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New! 3 days agoManage investigative case load, collect and preserve detailed information, prepare detailed post-audit investigative reports, and attend educational opportunities to keep apprised of developments in healthcare fraud.
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New! 3 days agoPerform complex research and analysis of healthcare claims, enrollment, and other related data. Develop reporting tools and translate complex data into meaningful information for decision-makers. Collaborate across departments within a multi-function...
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New! 3 days agoSubmit accurate and timely insurance claims, follow up on denials, and resolve discrepancies. Maintain work queues, reconcile accounts, and research and resolve issues relating to payments, denials, and non-payment of claims.
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New! 3 days agoHandle Private/Non-Profit D&O, EPL, and Fiduciary claims. Analyze coverage, liability, and damages. Participate in mediations and negotiating settlements. Monitor and manage activities of defense counsel and legal spend.
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New! 3 days agoCoordinate and administer casualty and property insurance claims. Manage Workers' Compensation claims and ensure compliance with policies and regulations. Develop and implement workers' compensation procedures and programs. Provide guidance on casualt..
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New! 3 days agoProvide excellent customer service by answering customer questions about disability and leave management claims. Utilize multiple computer applications to accurately document claim information. Receive 8 weeks of paid training and ongoing coaching and..
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FeaturedNew! 3 days agoHandle and maintain claims and file reviews, investigate and settle claims, evaluate facts supplied by investigation, and settle claims promptly and equitably. Strong communication, negotiation, and analytical skills required.
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New! 3 days agoManage denials and appeals process, ensuring regulatory compliance and internal policies/procedures adherence. Analyze trends, identify improvement opportunities, and provide expert guidance to team. Lead and manage others in a matrixed/cross-function..
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New! 3 days agoSubmit electronic and hard copy billing, investigate and coordinate insurance benefits, resolve accounts for maximum reimbursement, and handle research and follow-up activities in a fast-paced environment.
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New! 3 days agoIdentify, analyze, and resolve insurance company denials. Provide insight and analytics on medical insurance claims. Verify insurance eligibility, research billing issues, and follow up on unpaid claims.
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New! 3 days agoManage a branch claims office, develop and implement policies and procedures, represent the branch in relationships with agents, insurers, and vendors, and collect and analyze information for resolving problems related to critical IT production services.
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New! 3 days agoManage a team of 5-7 claims handlers to handle complex, high-profile claims. Ensure strong coverage analysis, expense, and litigation management. Evaluate claims reserve practices, build relationships, and analyze claims trends.
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New! 3 days agoInvestigates high-risk cargo loss and damage claims, evaluates liability and potential damages, collaborates with senior leaders to improve legal processes, represents the company in court proceedings, and develops litigation strategies.
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New! 3 days agoPromote and sell products, service policies, assist car enthusiasts, maintain compliance. Provide excellent customer service, problem-solving skills, multitasking abilities, and computer application proficiency. Utah residents only, remote work.
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New! 3 days agoPromote and sell products, service existing policies, claims and membership needs, assist customers through billing, service and sales needs. Deliver high level of customer service and maintain compliance.
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New! 3 days agoAccurately generate and submit medical claims, reduce accounts receivable, review clinical documentation, generate and analyze reports, collaborate with internal departments, maintain compliance with healthcare regulations, and keep accurate records...
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New! 3 days agoPromote and sell products, service existing policies, claims and membership needs, assist car enthusiasts and partners. Deliver high level of customer service, multitask and prioritize, work independently or within a group. $19/hr with full benefits. ..
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New! 3 days agoPromote and sell products and services to customers. Service existing policies and claims. Assist customers with billing, service, and sales needs. Provide excellent customer service and maintain compliance.
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New! 3 days agoResponsible for processing and handling escalated claims, analyzing claims for validity, and providing resolutions. Communicates with internal and external partners, proactively manages target dates, and identifies and resolves operational obstacles.
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New! 3 days agoManage an assigned caseload of Long Term Disability cases, evaluate customer eligibility, and interact with internal and external customers. Develop and document Strategic Case Plans, network with customers and physicians, and make fair, accurate, tim..
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New! 4 days agoSupport the Pharmacy Department's operations, provide customer service for member/provider inquiries, manage prior authorizations, and have knowledge of managed care and pharmacy call center experience.
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