Expedite and oversee administrative process of clients' insured claims as assigned within region, including but not limited to general liability, builders' risk, professional liability, pollution, and auto liability claims. Essential Duties & Key Responsibilities As directed by Claims Manager, report claims in timely manner to applicable insurance carriers, and gather per

Prepare, process and maintain new member or group enrollments Respond to member eligibility or group questions and verify enrollment status Reconcile eligibility discrepancies, analyze transactional data and submit retroactive eligibility changes Research errors by comparing enrollment error reports against system information along with records from the Center for Medicar

Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer Processes all types of medical claims and adjusts medical disputed claims (Professional and Facility) according to department, contract, and regulatory requirements

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Behavioral Health Registered Nurse Case Manager will report to th

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Claims Insurance Manager Medical Profe

REQUIRED EXPERIENCE Take on a significant role within a world class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level. You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying d

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Incumbent is responsible for obtaining all necessary authorizations in accordance with established guidelines. Verifies eligibility, obtains benefit information, and generates letters for authorizations. Responds to Member Services and Call Center inquiries and resolves any identified authorization issues which arise. Total Compensation In addition to the salary range lis

Working under the direction of the Director, Business Applications & Analytics, this position is responsible for performing alpha and numerical data entry and data verification functions according to established procedures using Teleform, member research in IDX, and mailing of correspondence. The Claims Verifier will perform duties in accordance with guidelines set forth

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Coding Compliance Auditor (HIM Inpatient) HIM Financial Full Time 8 Hour Days (Non Exempt) (Non Union) Apply Keck Medicine of USC Hospital Alhambra, California In accordance with current federal & state coding compliance regulations and guidelines, the 'IP Coding Compliance Auditor" performs 2nd level reviews of previously coded inpatient accounts for MS DRG validation pu

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom