as needed. Leads BI Help Desk effort by assuring the resolution of customer inquiries for navigation support, and user/system error... resolution experienced when using customer facing information delivery platforms. Analyzes needs of internal customers...
and assist in daily resolution of revenue integrity edits that are holding patient claims from billing, by reviewing the medical...
to eligibility/QLE, contributions, claims, overpayments, and general account maintenance. Complete custom processes and initiatives... and/or participant issues for resolution. This position requires cross-functional teamwork skills as well as system and product knowledge...
, resolution of entry problems, and support of broker supervision Assist with the product classification using the Harmonized... in the preparation of drawback claims. Comply with all other requirements of Signet’s Customs Compliance Manual, Desktop...
remittance advice. Accurately identify an invoice from an EOB to apply information for invoice resolution from an insurance... knowledge of CPT, ICD, HPCS, usage in the billing of physician professional claims, as well as strong knowledge of account...
related to eligibility/QLE, contributions, claims, overpayments, and general account maintenance. Complete custom processes... and/or participant issues for resolution. This position requires cross-functional teamwork skills as well as system and product knowledge...
. Roles and Responsibilities Serve as subject matter expert (SME) for resolution of issues related to claims adjudication... claims from hospital, ancillary, and provider groups based on the provider contract language Recommend changes in procedures...
staff in the prompt, equitable resolution of claims. Provides consultative and resource support to staff regarding...Major Responsibilities: Collaborates with claims adjustors and defense counsel in managing claims including...
staff in the prompt, equitable resolution of claims. Provides consultative and resource support to staff regarding... Responsibilities: Collaborates with claims adjustors and defense counsel in managing claims including assessment of liability...
a crucial role in overseeing daily IT support and operational activities, including the investigation and resolution... and business applications such as Employee and Employer Benefits, Claims, Single Sign On setup, Annual enrollment processes...
to create changes to allow our sales, claims, and product teams to operate accurately, quickly, and effectively. The ideal... new system request changes for UW, Sales & Claims Ensure the process follows company-assigned business rules Attend the...
Responsible for functions related to pharmacy coding and billing; participate in the resolution of pharmacy billing issues. Ensure... against prescription records. Job Description Reviews and completes coding, claims, and denials for medications, supplies, and diagnosis...
Responsibilities The HIS Coding Denials Coordinator is responsible for evaluating and resolving denied claims... is needed for resolution. Reviews all denial accounts for categorization, level of appeal, special requirements for initiating appeals...
HIS Coding Denials Coordinator is responsible for evaluating and resolving denied claims within the Coding department under the... to determine if coding needs to be changed or if an appeal is needed for resolution. Reviews all denial accounts...
here. Summary Responsible for the resolution of disputes on escalated claims, utilization management, or other denials. Reviews...
, ensuring accurate issuant of car hire claims, and problem resolution of the fleet’s error default rates changes. Generate...
concerning benefit and fee schedule interpretation NCCI (National Correct Coding Initiative) and other claims issues. Researches... incoming appeals and determines final resolution based on health plan policies and procedures. Uses knowledge of Medicaid rules...
, ensuring accurate issuant of car hire claims, and problem resolution of the fleet’s error default rates changes. Generate...
. Excellent communication skills. Ability to document complex problems and assist in their resolution. Ability to understand... Service) Claims and Data Analytics Team (We support testing of work efforts/projects for all LOBs. Immediate Team – approx...
required Knowledge, Skills, and Abilities Demonstrated understanding of benefits terminology, plan design, claims resolution...