Contacts insurance carriers / patients regarding outstanding insurance claims to obtain proper payment based on EOB and / or Experian contract modeling expectations. Knowledge of clinic operating policies to help in the identification of denial root causes. Prepares proper documentation for appeals to insurance carriers. Processes the appealing of claims reimbursed incorr

Serve as primary contact as it relates to all enrollment tasks for assigned book of business, which include multiple group customers; maintain satisfied customers by providing superior service and practice attention to detail in various responsibilities. Answer member, provider, and group customer phone calls; adhering to department expectations for answering calls and pr

Administration of Pension Benefits Collection of data from pension participants to determine eligibility and vesting schedule. Answer questions via telephone and email to convey information regarding the provisions of the pension plans. Create various types of members or employer correspondence including letters and emails. Collection and data entry of participant hours w

Under the supervision of the Director of Compliance, the analyst will manage, develop, implement and monitor policies, procedures, processes, training, corrective action plans and overall operations to ensure compliance with federal and state laws and regulations affecting the Medical System and its Affiliates. Additionally, the Analyst will work collectively with Affilia

Job Announcement Serves as part of the Financial Section in the Criminal Division. Performs various financial duties with a primary focus on the calculation of court fines, fees, and interest, and the processing of payments received by mail, over the phone, and in person. In addition, this position is responsible for customer service, records management, and other adminis

Complex Asst. Director of Finance Requisition ID 2024 52322 Category Accounting/Finance Job Location US NV Las Vegas Property Renaissance Las Vegas Hotel Compensation Type Yearly Highgate Hotels Highgate is a leading real estate investment and hospitality management company widely recognized as an innovator in the industry. Highgate is the dominant player in major U.S. ga

PRIOR AUTHORIZATION SPECIALIST Job Locations US CO ENGLEWOOD ID 2024 142388 Line of Business Amerita Position Type Full Time Pay Min USD $18.50/Hr. Pay Max USD $28.00/Hr. Our Company Amerita Overview Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. A

Data Analysis and Reporting Gather, organize, and analyze clinical data from various sources within GEHA. Develop comprehensive reports and presentations for senior leadership, providing insights into clinical operations, outcomes, and performance metrics. Clinical Performance Assessment Evaluate clinical performance indicators, identifying trends, patterns, and areas for

The Regulatory Compliance Analyst supports the compliance function through assisting with regulatory examinations, researching regulatory changes at the state and line of business level, collaborating with other business units, Corporate Legal, and various compliance teams to proactively ensure compliance with regulatory requirements. Conducts regulatory research projects

Sells appropriate products, features, and services based on customer needs. Resolves customer pain points in one interaction utilizing in store systems and digital tools. Coach in all directions and provide actionable feedback that improves performance. Takes ownership of store performance. Lead by example in training completion and staying up to date on product and servi

Greet all outpatients and visitors, determine reason for visit to the department and verify the following for scheduled appointments accuracy of identity, prescription, medical insurance, and confirm all demographic and contact information. Accurately update/change/complete any registration records information, as needed. Complete/Scan ID cards, Insurance Cards, Referral

A day in the life of a Patient Access Specialist for Oncology with Hackensack Meridian Health includes Obtains Referrals/Authorizations and Verifies eligibility, submits requests for prior authorizations for all oncology services as prescribed by the Clinical care team and conformance to Hackensack Meridian Oncology/Radiation standards and protocols within the network. Su

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Insurance Specialist is responsible for assuring all appointments and procedures are authorized. Insurance

The Insurance Follow Up Specialist contributes to the financial viability of the organization by assuring that accounts have been properly billed and reimbursed. Responsibilities include contacting the appropriate insurance company to secure and expedite payments through the follow up and appeals resolution processes, and acting as a functional leader or reference source.

1. Respond to fraud related inquiries and referrals to SIU from Claim Specialists and Examiners and from automated initial screening system; search restricted, subscription based and public databases, making maximum use of web based resources; identify circumstances potentially requiring retention of investigators and/or referral to regulatory or law enforcement authoriti