: Utilization Management Representative II Location: This position will work a hybrid model (remote and office). Ideal candidates... will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative II will be responsible...
and miscellaneous bureau policies via telephone, one-on-one and group discussions. Prepare detailed written violative profile for cases... representative on the special committee, the Commercial Pesticide Applicator Peer Review Panel. Performs general administrative...
satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable... Ability to interpret a variety of state and federal regulations and determine affect on CDM and claims production Conifer requires...
claim follow up. ESSENTIAL FUNCTIONS OF POSITION Responsible for reviewing and submitting clean claims to third party... payers Maintain patient billing files through electronic records system Review and assess adjudicated claims for timely...
Overview In the complex web of health care insurance and claims, you are a calm, organized problem-solver... reimbursement; removes barriers to processing claims; negotiates financial arrangements and individual contracts with third-party...
and responds by telephone, or in writing to complex patient inquiries regarding billing issues and problems. 25% Reviews billing... duty satisfactorily. The requirements listed below are representative of the knowledge, skill...
and responds by telephone, or in writing to complex patient inquiries regarding billing issues and problems. 25% Reviews billing... duty satisfactorily. The requirements listed below are representative of the knowledge, skill...
Provider Relations Representative I performs a variety of routine and semi-routine tasks requiring a thorough knowledge... and metrics may be eligible to be promoted to a Provider Relations II role once they have worked as a PR I for a minimum of 12...
Call Center, the Provider Relations Representative I performs a variety of routine and semi-routine tasks requiring... performance objectives and metrics may be eligible to be promoted to a Provider Relations II role once they have worked as a PR...
us forward every day. Job Overview The AR Representative II position is responsible for generating and submitting timely health... insurance billing claims and/or patient statements. Includes follow up on unpaid claims and resubmission of unpaid claim...
member records (name, address, telephone numbers, etc.) Provide notary services if commissioned Comply with the Bank... members with ATM and fraudulent account activity claims; obtain signed forgery affidavits and supporting documents; contact...
member records (name, address, telephone numbers, etc.) Provide notary services if commissioned Comply with the Bank... and fraudulent account activity claims; obtain signed forgery affidavits and supporting documents; contact appropriate credit union...
MAJOR RESPONSIBILITIES Responsible for daily claims submissions to the appropriate payer source. Communicates... with internal and external parties to resolve charging issues affecting the claims. Reports trends with other departments that may...
Responsible for daily claims submissions to the appropriate payer source. Communicates with internal and external parties... to resolve charging issues affecting the claims. Reports trends with other departments that may improve the claims submission...
and processes incoming workers' compensation claims. Performs tasks such as the following: Reviews accident reports... and other documents related to incoming claims to determine workers' compensation coverage. Sets up computer files, enters information...
diploma or equivalent. Ability to complete training as a Customer Service Representative with Moda Health. Claim processing... or a combination of two of these, depending on existing skills and training. Opportunity for promotion to Health Navigator II upon...
of their work, and above average customer service with all patients. The Technician II helps coordinate 3rd party claims, places...Job Description The Pharmacy Technician II provides support to pharmacists and managers in all aspects of providing...
Job Description: JOB SUMMARY The Patient Accounts Specialist II prepares and follows-up all third party and patient... receivable utilizing A/R reports and received correspondence and other department inquiries Review and assess adjudicated claims...
Job Description Under direct supervision, receives and processes incoming workers' compensation claims. Performs... tasks such as the following: Reviews accident reports and other documents related to incoming claims to determine workers...
Professionally greet and engage patients and customers as they enter the pharmacy or on the telephone Properly respond to or triage... use and documentation Resolving rejected claims by speaking with pharmacist, coworkers, providers or third-party insurance companies...