Claims Processing Jobs in USA

The Business Relationship Manager is responsible for building and maintaining positive relationships with internal and external customers understanding the complex nature of the companys business and products offered and aligning business and system requirements for receipt and processing of bordere...

SummaryResponsible in the provider enrollment process to review research analyze and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines.DescriptionLogistics: CGS () one of BlueCross BlueShields Sout...

As a Health Services Coding Analyst you will provide clinical leadership and subject-matter expertise to support the analysis configuration and administration of complex medical policy content within claims processing systems including Plan General Exclusion (PGE) rules and FACETS table maintenance....

As a Health Services Coding Analyst you will provide clinical leadership and subject-matter expertise to support the analysis configuration and administration of complex medical policy content within claims processing systems including Plan General Exclusion (PGE) rules and FACETS table maintenance....

As a Health Services Coding Analyst you will provide clinical leadership and subject-matter expertise to support the analysis configuration and administration of complex medical policy content within claims processing systems including Plan General Exclusion (PGE) rules and FACETS table maintenance....

City/StateVirginia Beach VAWork ShiftFirst (Days)Overview:Claims Resolution CoderResponsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI) Medicare Outpatient Code Editor (OCE)or other third party p...

DescriptionJob SummaryThe Billing Specialist I is responsible for performing insurance claim processing billing and follow-up to ensure timely and accurate reimbursement. This position serves as the primary contact for insurance companies and other payers researching and resolving claim issues while...

DescriptionAs a Billing Specialist at Merit Health youll join a team and be a part of a culture thats dedicated to providing top quality care to our patients. Our full-time employees enjoy a robust benefits package which may include health insurance 401(k) licensure/certification reimbursement tuiti...

Employment Type:Full timeShift:Day ShiftDescription:POSITION PURPOSEWork Hours: 10:30 a.m. to 7:00 p.m. (EDT) - Monday thru FridayWork Remote Position(Pay Range: $19>2123-$28.8184)Performs day- to- day customer service activities within the hospital revenue operations of an assigned Patient Business...

SummaryResponsible in the provider enrollment process to review research analyze and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines.DescriptionLogistics: CGS () one of BlueCross BlueShields Sout...

Join Martins Point Health Care - an innovative not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force ofpeople caring for people Martins Point employees are on amission to transform our health care system while creating a healthier com...

Job Description: Summary:Under the guidance of the SIU Management this position is responsible for the accurate and thorough clinical investigation of potential fraud waste and abuse (FWA) for all lines of business. The scope of accountability includes investigating and remediating allegations of FW...

Act as a conduit between clients who bill medical insurance claims electronically and Quadax. The Account Representative is the face of Quadax and interacts with both clients (hospitals and physician practices) and Quadax personnel alike. Seeking candidates based in Madison or Milwaukee WI. This pos...

Act as a conduit between clients who bill medical insurance claims electronically and Quadax. The Account Representative is the face of Quadax and interacts with both clients (hospitals and physician practices) and Quadax personnel alike. Seeking candidates based in Madison or Milwaukee WI. This pos...

DescriptionJob SummaryObtains accurate demographic financial and clinical information and enters into the computer system to create the medical and financial record. Applies financial guidelines to determine/collect patient liablity. Performs other duties as assigned.ResponsibilitiesRegisters patien...

Job Summary:The roles primary responsibility is ensuring staff execution of tasks in a compliant manner associated with Richters policies and procedures. The Associate Manager will provide leadership to team members and positively impact the accurate and timely billing and collection processes for R...

DescriptionAt Bristol Health we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients residents and families. We are committed to provide compassionate qua...

Position: Senior QA/QE Engineer Location: Oakland CA*Day 1 Onsite Job Qualification: Role/Responsibilities Execute and coordinate QA/QE activities across two application teams simultaneously Design develop and maintain test plans test cases and test scripts for functional regression and...

The Unemployment Claims Manager is responsible for overseeing the end-to-end management of unemployment insurance claims across multiple U.S. states. This role ensures compliance with federal and state unemployment laws manages claims processing operations and leads a team responsible for responding...

As the Claims Senior Analyst youll support the day-to-day operations and continuous improvement of Best Buys Final Mile Claims this role youll manage the full lifecycle of claims processing including intake investigation resolution and partner communication. Youll collaborate with delivery partners...