Remote RN – Medical Claims Reviewer - United States - Remote

We transform challenges into opportunities with expert program management,cutting-edge technology,and innovative consulting solutions. · Performs medical claim reviews for one or more of the following:claims for medically complex services,services that require preauthorization/pr ...

Assist the Director of HIM in preparing claim audits, reviewing and recommending coding, revenue cycle and charge/billing changes on client hospital outpatient and Profee claims using proprietary software product. · ...

This position will report to the Claims Manager, playing a unique and important role in our mission to change healthcare for the better. Experience in the healthcare industry and critical thinking skills will help the organization build an effective and efficient claims team. · T ...

The successful candidate will be a rockstar at identifying analyzing and resolving insurance company denials. · Verifying insurance/recipient eligibility billing and follow-up on claims to Medicare Medicaid and Private Insurer Payers. · ...

This role will be responsible for direct handling of multi-line commercial claims with a focus on New York Labor Law. Duties include investigation and evaluation of coverage, liability and damages issues. · Investigation and evaluation of coverage, liability and damages issues. · ...

This role will be responsible for monitoring reviewing and coordinating the activities of TPAs handling multi-line commercial cases with an emphasis on worker's compensation claims. · ...

Medical Billing Specialist is responsible for Posting medical charges, payments, and journal entries to patient accounts in a timely and accurate manner. · ...

A medical biller is responsible for posting medical charges and payments to patient accounts in a timely and accurate manner. · ...

The Claims Manager will handle all insurance claim matters presented by clients of Risk Strategies Group and manage the operations/workflows of the Claims Department staff. · Setup and submit new claims to insurance carrier and place on follow-up activity diary review verify cove ...

We insure a variety of public entities such as cities townships police and fire departments in over 20 states throughout the Country. · ...

The Claims Quality Improvement Specialist will support claims efforts while assisting the Claims Quality Improvement Manager in improving our overall Claims organization. · ...

The Claims Quality Improvement Specialist will support claims efforts while assisting the Claims Quality Improvement Manager in improving our overall Claims organization. · ...

The Tokio Marine HCC - Public Risk Group is seeking a self-motivated Claims Attorney to join our growing Claims Department and handle litigated and non-litigated claims primarily arising under Auto and General Liability. · This position involves interpretation of coverage and req ...

This role will be responsible for direct handling of commercial claims specific to General Liability and/or Excess General Liability. · Familiarity with SME involving premises liability. · Investigation and evaluation of coverage, liability, risk transfer and damages issues. · ...

The Claims Manager is a fully remote role responsible for serving as a liaison for clients in the management of Workers' Compensation claims. · Educate Clients on Claims Management Procedures · Coordinate Claims Strategy with Clients, Adjusters, Attorneys, and Doctors · Analyze C ...

Experienced Medicare Biller prepares and submits hospital claims to Medicare and follows up on unpaid claims. · Maintains quality customer service by following company policies. · ...

+p>The Sr. Auditor, Quality Assurance position is responsible for ensuring that the audited claims meet quality standards necessary to generate high quality recoverable claims for the benefit of Cotiviti and our clients. ...

We have an exciting opportunity for a Contract Claims Auditor to join our audit team as a consultant. This role would be supporting one of our clients and apply your expertise specifically across lender-focused insurance products. · ResponsibilitiesReview hazard placement, docume ...

We are transforming senior care by providing an all-inclusive healthcare option. · Ensuring timely and efficient processing of claims for our contracted specialty provider partners. · ...

A DBA Claims Specialist is responsible for reporting Foreign and Maritime work-related injuries and illnesses to insurance carriers third-party administrators and the Department of Labor. · ...