Reviews payer EOB's but not limited to payment accuracy, patient liability, and appeal grievances. Work 60 accounts daily Files appeals on denied claims and/or forwards to the Nurse Auditor for review Process incoming mail correspondence from payers within 5 business days. Follow up with the insurance companies by phone and or web for the status of outstanding claims. Fol

Account Servicing Responds to service requests and proactively identified service needs. Manages new and existing insurance customer activities including policy check in, renewals, cancellations, endorsements, and initial claim activity. Performs data entry, processing, and risk analysis at an advanced level. Ensures accuracy and compliance with all rules and regulations.

The Data Entry Clerk is responsible for inputting lists of items, numbers, or other data into the computer; or completing forms that appear on a computer screen. The Data Entry Clerk may also manipulate existing data, edit current information, or proofread new entries to a database for accuracy. Essential Functions and Responsibilities 1. Apply client specifications to ac

The Commercial Account Manager is responsible for assisting clients with service needs and making changes to existing accounts, meeting service, and sales delivery standards, and performing essential functions to achieve the quality and service standards developed by the agency. This position will assist Producers and Account Executives in the handling and processing of n

The Commercial Lines Assistant Account Manager is responsible for assisting other members of the department with meeting the service needs of customers and performing essential functions that include processing changes, rating, making calls, and assuring correct information is input into the automation systems to achieve the quality and service standards developed by the

The Commercial Lines Assistant Account Manager is responsible for assisting other members of the department with meeting the service needs of customers and performing essential functions that include processing changes, rating, making calls, and assuring correct information is input into the automation systems to achieve the quality and service standards developed by the

The Commercial Account Manager is responsible for assisting clients with service needs and making changes to existing accounts, meeting service, and sales delivery standards, and performing essential functions to achieve the quality and service standards developed by the agency. This position will assist Producers and Account Executives in the handling and processing of n

Primary Duties and Responsibilities (details of the basic job functions) Assist in the implementation and oversight of The Auto Club Group (ACG) membership sales and service delivery in multiple retail locations across assigned region. Play a key role in the delivery of exceptional membership experience. Develop and implement initiatives to drive the attainment of members

Authorization Specialist (full time, days) Facility Riverview Regional Medical Center Location US AL Gadsden ID 2024 160502 Category Admin Position Type Full Time Shift Days Job Type Non Exempt Overview Benefits Statement We offer Competitive Compensation Generous benefits plan Medical, Dental, Vision, 401K Collaborative work teams & cohorts ...and much more! We would lov

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary Under Supervision, This Position Is

In this role, you will lead contract negotiations with current and prospective suppliers for aptitude, collaborating with multiple departments and business stakeholders. You will build internal and external relationships, utilize data driven insights and develop contract strategies that deliver value to the providers and suppliers that we support. You will also manage var

Find your place at The Partners Group, a purpose driven company committed to making a difference in our community through our work and inspiring others to do the same. TPG’s success is driven by a culture that values partner ships. We’re looking for people who invest in their relationships, seek to learn, create winning solutions for all, and do what they say

Reviews, processes, and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. Provides prompt feedback to physicians and management regarding pathway documentat

The essential duties and responsibilities (including but not limited to) Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.

The essential duties and responsibilities (including but not limited to) Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.