in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating..., negotiating, and processing claims. Authorizes the appropriate payment or refers claims to investigators for further review...
or general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims. Analyze... with CSP facets Claims processing in facility or physician Ability to work an 8-hour shift between the hours of 5:00AM -7:00PM...
. Works with others as part of a team. Claims Processing Systems/Resources Use appropriate systems/platforms/applications... to process claims . Navigate systems tools and screens efficiently and effectively (e.g., keyboard skills, macros, shortcuts...
in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating..., negotiating, and processing claims. Authorizes the appropriate payment or refers claims to investigators for further review...
. Works with others as part of a team. Claims Processing Systems/Resources Use appropriate systems/platforms/applications... to process claims . Navigate systems tools and screens efficiently and effectively (e.g., keyboard skills, macros, shortcuts...
Responsibilities: Process claims of $25,000 or more. Manage outbound calls Meet or exceed productivity expectations Meet or exceed... Claim QA expectations Priority Zero Provider Processing Application of Stop Loss Knowledge (Process stop loss claims...
Responsibilities: Process claims of $25,000 or more. Manage outbound calls Meet or exceed productivity expectations Meet or exceed... Claim QA expectations Priority Zero Provider Processing Application of Stop Loss Knowledge (Process stop loss claims...
. This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims to identify... U.S. as you take on some tough challenges. Primary Responsibilities: Provide expertise or general claims support by reviewing, researching...
U.S. as you take on some tough challenges. Primary Responsibilities: Review, research, analyze and process complex healthcare claims... appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates...
procedures. Utilizes Optum systems to resolve customer needs such as appointments, authorizations, claims, invoices, eligibility... without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation...
of experience with Enrollment or Claims processing 1+ years of experience with the AARP Medicare Supplement products Intermediate..., religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity...
: Perform research on assigned payer guidelines when processing appeals, corrected claims or denial reasons. Stay up... information Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication...
: Perform research on assigned payer guidelines when processing appeals, corrected claims or denial reasons. Stay up... information Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication...
across functions including Claims and Network Operations. This position is full time (40 hours / week), Monday - Friday. Employees..., religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity...
. You will also showcase your expertise by giving input on market price developments and tendencies. The work model for the role is: remote... strategy. Acts as focal point for problem resolution and monitors customer claims. Plans, facilitates and conducts customer...
REMOTE OPPORTUNITY ANYWHERE IN THE US! Investigates, evaluates, negotiates, and resolves property claims... expertise to many customers/clients on a national level, using a combination of virtual investigation and physical investigation...