misconduct, including the review of claims, clinical documentation, and billing practices. Conducts interviews, collects...), International Classification of Diseases (ICD-10)), medical billing, and claims review processes. Working knowledge of program...
misconduct, including the review of claims, clinical documentation, and billing practices. Conducts interviews, collects...), International Classification of Diseases (ICD-10)), medical billing, and claims review processes. Working knowledge of program...
Standards as a Master Plans Examiner, or must obtain such within six months of the date of hire. Certification as a Building... and processing; claims negotiation; and project reporting. Attend all project meetings. May assist in budget and work program...
as a result of the Alaska Native Claims Settlement Act (ANCSA) in 1972. BSNC became the regional Alaska Native Corporation (ANC...) and Medical Examiner’s Certificate (MEC). WORK ENVIRONMENT Work Environment characteristics described here are representative...
health compensation and pension exams for service connected issues and claims. The hours at the clinic fall between 8:00... trauma, PTSD, sleeping disorders, eating disorders and anxiety. This is an assessment only position. (B&H Examiner) Role...
of defense attorneys. This includes directing and reviewing litigation strategy and actions of defense counsel for claims... assessment of the exposure. Determines if the investigation supports the exposure analysis. Handles claims that are more complex...
as occasional on-site audits. Contribute to the review of reimbursement systems relating to health insurance claims processing... (CHC) Certified Fraud Examiner (CFE) OR Accredited Health Care Fraud Investigator (AHFI) preferred. (Note: Federal Agents...
health compensation and pension exams for service connected issues and claims. The hours at the clinic fall between 8:00... trauma, PTSD, sleeping disorders, eating disorders and anxiety. This is an assessment only position. (B&H Examiner) Role...
in Financial Services & Insurance OSS Coordinator PRIMARY PURPOSE: To support and maintain the claims management system.... ESSENTIAL FUNCTIONS and RESPONSIBILITIES Completes examiner update reports, claim adjustments, provider requests...
once commitments are fully satisfied • Analyze title searches for liens, judgments, claims, fraud risks, and defects... with excellent communication skills • 3-5 years of title closing experience, abstractor experience, title examiner or providing...
of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims data, applicable guidelines and other sources... trends Intermediate level of experience in Microsoft Excel and Word Intermediate level of knowledge in pharmacy claims...
of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims data, applicable guidelines and other sources... trends Intermediate level of experience in Microsoft Excel and Word Intermediate level of knowledge in pharmacy claims...
of experience as a Primary Patent Examiner with signature authority or Supervisory Patent Examiner who provides working knowledge... at all times Required Retired federal employee of the USPTO patent office with experience as a Primary Patent Examiner...
& RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner... Knowledge of workers' compensation claims process Prospective, concurrent and retrospective utilization review PAY RANGE...
Specialist with expertise in disaster fraud claims. This role is critical in evaluating and analyzing financial data related... to disaster-related claims, including property damage, business interruption, and other loss categories. The specialist...
to other appropriate internal teams as needed. Supports the provider escalation project team to resolve claims and payment issues... within established service level agreements, WellCare best practice and quality standards. Applies a comprehensive knowledge of claims...
: Maintain inventories, perform third party claims processing and filing, maintain MSDS files, perform bookkeeping duties... OR American Board of Opticianry Basic Certification required at hire AND National Contact Lens Examiner - Basic Certification...
responses, examiner interviews, and freedom-to-operate studies. We are seeking a Patent Agent with a background in mechanical... comprehensive specifications and claims Present findings, reasoning, and recommendations clearly to both technical and non...
Position Overview The Workers’ Compensation Claims Examiner is responsible for managing and resolving Texas workers...’ compensation claims while ensuring compliance with the Texas Department of Insurance–Division of Workers’ Compensation (TDI-DWC...