Correctly categorizes inquiries / complaints and refers cases appropriately to other departments for follow up; i.e. provider issues, or quality of care issues. Tracks all inquiries or complaints to ensure that cases are resolved within State required timeframes. Documents resolution and prepares and sends written correspondence in response to members initiating complaint

Contacts insurance carriers / patients regarding outstanding insurance claims to obtain proper payment based on EOB and / or Experian contract modeling expectations. Knowledge of clinic operating policies to help in the identification of denial root causes. Prepares proper documentation for appeals to insurance carriers. Processes the appealing of claims reimbursed incorr

Assist in end to end provider claims and help enhance provider experience Assist in efforts to enhance ease of use of provider portal and future services enhancements Support development and management of provider networks within assigned regions Help implement training and development of external providers through education programs in collaboration with our training tea

The Medical Billing Payor Verification for Government Payors will work with payor portals and payors via telephone communications to verify benefits, deductible and out of pocket amounts, primary, secondary, and tertiary payors. Problem solve and research and resolve coordination of benefits issues. Work as a team to meet team goals and deadlines. HOURS/WORK SCHEDULE Trai

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here. Applicants must be eligible to begin work on the date of hire. Applicants must be currently authorized to work in the United States on a full time basis. ARKANSAS BLUE CROSS BLUE SHIELD will NOT sponsor applicants for work visas in this position. Arkansas Blue Cross is only seeking

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

Salary $67,487.03 $80,846.68 Annually The County of Santa Barbara's Clerk Recorder Assessor Department is currently accepting applications to fill two full time v acancies in the Santa Barbara Assessor's Office. Please note The application and selection process does require you to complete an In Person Exam. The Santa Barbara County Assessor's Office has an incredible opp

1. Manage a high volume of healthcare claims thoroughly to maximize savings opportunities on each claim within the established department production standards and individual goals by contacting provider on all assigned claims and presenting a proposal while maintaining high quality standards. Perform provider research to provide support for desired savings Address counter

1. Manage a high volume of healthcare claims thoroughly to maximize savings opportunities on each claim within the established department production standards and individual goals by contacting provider on all assigned claims and presenting a proposal while maintaining high quality standards. Perform provider research to provide support for desired savings Address counter

WebTPA is looking to hire Medical Claim Examiners to join our team in Irving, Texas! Prior experience in Healthcare Claim Processing is needed. Key position details Our paid training program is scheduled to start August5, 2024. This is a fully in office position 8500 Freeport Parkway Irving, Texas 75063 Training schedule 8 00am 4 30pm Monday Friday GetToKnow Us! WebTPA, a

Member Service Specialist I Job Locations US Remote Overview We are CONNECTING HEALTH AND WEALTH. Come be part of remarkable. How you can make a difference While working from the confines of your home, this position will be responsible for crafting and maintaining positive customer relationships and responding to customer inquiries regarding all spending account products.