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Reviews, processes, and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. Provides prompt feedback to physicians and management regarding pathway documentat
Posted 1 day ago
As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy p
Posted 2 days ago
Hollister Incorporated
- Port St. Lucie, FL / Vista, CA / Clayton, GA / 10 more...
Work Location Remote Candidates must reside in one of the following states Florida, Georgia, Virginia, Pennsylvania, Ohio, Tennessee, Alabama, Illinois, Minnesota, Arkansas, Texas, Colorado, California, Washington You Will (Responsibilities) The Provider Enrollment Specialist is responsible for assisting with all aspects of licensing, credentialing, and application enroll
Posted 3 days ago
James River Management Company
- Alpharetta, GA / Raleigh, NC / Richmond, VA / 1 more...
The Senior Claims Examiner will manage a caseload of insurance claims pending under a moderate to low level of supervision. Job functions include the following Analyzing insurance claims to determine applicable coverage; Analyzing claims to determine the extent of insured's or insurer's liability; Reviewing and evaluating damages and determining strategies for resolution.
Posted 9 days ago
ZOLL Cardiac Management Solutions
- Pittsburgh, PA / Hagerstown, MD / Asheville, NC / 47 more...
The Intake Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of new medical orders from hospitals and physician offices. This individual is responsible for front end functions of the order fulfillment process. Individual will work with numerous insurance types in reviewing medical orders and clinical document
Posted 5 days ago
Support assigned supervisor and members of the team in routine office administration, personnel, time and attendance, database administration, and project requirements; Responsible for all administrative and IT requirements for in processing or newly arrived personnel; including, but not limited to, submission of requests for computer and facilities access and issuance of
Posted 15 days ago
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the
Posted 6 days ago
Responsible for registration process of new and current patients at the site. Completes check in and check out functions to include collection of co pays, scheduling of appointments, and requests for medical records. Answers telephone calls and greets all patients and visitors with a smile. Must have ability to communicate with insurance carriers and discharge planners in
Posted Today
Calls insurance companies to verify benefits of the patient. Completes insurance verification and summary of reimbursement and liability forms. Reviews demographic and insurance information in patient accounts and make necessary corrections as needed. Notes in each account a brief summary of information received from the insurance company. Scans assignment of benefits, ve
Posted 20 days ago
Analyzes, defines, and documents requirements for data, workflow, logical processes, hardware and operating systems environment, interfaces with other systems, internal and external controls and output. Develops system software code using commonly known best practices. Willing to adhere to Navy Federal Credit Union (NFCU) standards and policies regarding software developm
Posted 13 days ago
Responsible for registration process of new and current patients at the site. Completes check in and check out functions to include collection of co pays, scheduling of appointments, and requests for medical records. Answers telephone calls and greets all patients and visitors with a smile. Must have ability to communicate with insurance carriers and discharge planners in
Posted 1 day ago
Responsible for registration process of new and current patients at the site. Completes check in and check out functions to include collection of co pays, scheduling of appointments, and requests for medical records. Answers telephone calls and greets all patients and visitors with a smile. Must have ability to communicate with insurance carriers and discharge planners in
Posted 1 day ago
Responsible for registration process of new and current patients at the site. Completes check in and check out functions to include collection of co pays, scheduling of appointments, and requests for medical records. Answers telephone calls and greets all patients and visitors with a smile. Must have ability to communicate with insurance carriers and discharge planners in
Posted 1 day ago
Responsible for registration process of new and current patients at the site. Completes check in and check out functions to include collection of co pays, scheduling of appointments, and requests for medical records. Answers telephone calls and greets all patients and visitors with a smile. Must have ability to communicate with insurance carriers and discharge planners in
Posted 5 days ago
Responsible for review of the clinical information received from physicians, department queues and other clinical providers, ensuring clinical data is substantial enough to authorize services for both 1 time visit account types and recurring accounts. Analyzes clinical information to ensure the services requested are authorized according to clinical and payer protocols. R
Posted 6 days ago
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