Claims Jobs in Columbia
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Search Results - Claims Jobs in Columbia
Paladin Consulting, Inc-Columbia
Duties
Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non...
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Addison Group-Columbia
client’s team. This role involves handling follow-up for rejected or denied insurance claims, performing edits in the clearinghouse system, and managing communication with patients and providers. The ideal candidate will bring a strong background...
mindmatch.ai -
US Tech Solutions, Inc.-Columbia
Job Description:
Mon-Fri 8-4:30 onsite 6 week training
Working claims stopped on local system
Responsibilities:
Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational...
resume-library.com -
US Tech Solutions-Columbia
sets or clinical guidelines. Provides support and review of medical claims and utilization practices.
May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes...
mindmatch.ai -
The Vertex Companies, LLC-Columbia
Job Description
Vertex is seeking a Construction Claims Consultant to join our Surety team! This role provides the opportunity to leverage your expertise in evaluating construction claims, assess project risks, and support surety providers...
resume-library.com -
Experis-Columbia
and medical necessity guidelines.
6. Utilize resources for review determinations and make referrals to appropriate staff, such as Medical Directors or Case Managers.
7. Input clinical data into systems to support claims adjudication and information flow...
LanceSoft Inc-Columbia
Manages the research and development of new products. Works with various functional areas (marketing, underwriting, actuarial, claims, information systems, finance) to provide innovative approach to new product lines.
30% Identifies, researches...
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Amerihealth Caritas-Columbia
the Internet, data analysis tools, etc., to analyze aberrant;claims billing and practice patterns.
• Analyzes data as part of the investigative process using available fraud detection software and corporate resources.
• Represents ACFC in conducting settlement...
Paladin Consulting, Inc-Columbia
program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and evaluate medical necessity, options, and services required to support...
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Broadway Ventures-Columbia
Preferred Qualifications:
• Bachelors degree in Business Administration or Health Administration.
• Two (2) years of call center experience.
• Experience with Medicare A/B MAC and PECOS.
• In-depth knowledge of provider certification processes, claims...
mindmatch.ai -
Experis-Columbia
and provide support and review of medical claims and utilization practices.
• Educate internal/external staff regarding medical reviews, medical terminology, coverage determinations, and coding procedures.
• Participate in quality control activities...
Rose International-Columbia
Flexible and able to manage client relationships
• Analysis and problem-solving skills to resolve operational problems and improve reporting performance
• Quantitative data analysis skills for analyzing claims and encounter data
• Ability to summarize...
mindmatch.ai -
GLOBAL MEDICAL STAFFING-Columbia
Credentialing not needed
• DEA needed
Description
To get this new adventure started, pick up the phone and call us today.
• Competitive compensation
• Pre-paid travel and housing
• Paid AAA-rated claims made malpractice
• Licensing assistance and cost...
appcast.io -
US Tech Solutions-Columbia
skills. Knowledge of claims systems. Presentation skills.
Preferred Software and Other Tools: Excel or other spreadsheet software. Ability to effectively use Microsoft Office applications, such as Word, Power point and Excel. Work Environment: Typical...
mindmatch.ai -
Experis-Columbia
and guidelines.
• Review medical claims and determine reasonable charge payments.
• Ensure authorization of medical services based on benefit guidelines.
• Review interdepartmental requests for medical information to support utilization processes.
• Conduct...
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