Claims Resolution Expert

Policy Resolution Expert:We are seeking a Policy Resolution Expert to join our team. As a Policy Resolution Expert, you will be responsible for managing and resolving insurance claims, ensuring that our customers receive the best possible service.You will be responsible for reviewing and processing insurance claims, identifying potential issues, and making...

Job SummaryThe Claims Reconciliation Expert position at John Clements Consultants, Inc. involves coordinating and facilitating claims and payment reconciliation processes. The ideal candidate will possess excellent analytical skills, attention to detail, and strong communication abilities.Reconciliation Tasks: Coordinate with cross-functional teams to...

Key ResponsibilitiesClaim Management: Manage insurance claims from start to finish, ensuring timely and accurate resolutions.Assessment and Reporting: Conduct thorough assessments and prepare comprehensive reports for clients.Customer Interaction: Build strong relationships with customers, clients, and internal stakeholders through effective communication...

Job DescriptionThis position is responsible for identifying, capturing, tracking, reviewing, and resolving held claim edits, claim rejections, and/or denials that result from the claims/billing cycle.Main Responsibilities:Identify and track revenue cycle held claim edits, rejections, and/or denials including verifying legal health record documentation to...

Key ResponsibilitiesThis role requires a strong working knowledge of ICD-10-CM, ICD-10-PCS, HCPCS, CPT codes, modifiers, charging, and payment methodologies.Critical Thinking and Analysis:Apply critical thinking and research skills to resolve complex claim issues and ensure accurate and compliant claims processing.Maintain proficiency in injection and...

ResponsibilitiesAs a Claims Processing Expert at Optum, you will play a critical role in ensuring the smooth operation of our medical claims collection process. Your responsibilities will include:Collecting and processing medical claims from healthcare providersWorking closely with insurance companies to verify claim status and resolve payment...

Job SummaryKMC Solutions is seeking an experienced Healthcare Claims Expert to join our team in Ortigas CBD, Pasig. As a key member of our revenue cycle team, you will be responsible for preparing and submitting clean claims to insurance companies via electronic and paper submissions.The ideal candidate will have at least 12 months of experience in medical...

About the Role:The Insurance Claims Coordinator plays a vital part in our team, responsible for overseeing and managing insurance claims from initiation to resolution. This role demands attention to detail, effective communication skills, and a deep understanding of insurance claims processes.We are seeking a Claims Processor with a Bachelor's degree in a...

Job Description:We are looking for a skilled Healthcare Claims Collections Representative to join our team at Optum. As a key member of our operations team, you will be responsible for ensuring timely and accurate processing of healthcare claims.You will work closely with healthcare providers to resolve payment disputes and collect outstanding balances.You...

Job Overview:KIA is seeking a highly skilled Warranty Processor to join our team. As a Warranty Processor, you will play a critical role in ensuring the efficient and effective processing of warranty claims and parts repairs and replacements.The successful candidate will be responsible for collecting warranty defective parts and submitting them to...

The Claims Insurance Coordinator will be responsible for overseeing and managing insurance claims from initiation through resolution. This role requires attention to detail, effective communication skills, and a deep understanding of insurance claims processes.Graduate of Bachelor's degree in a related field2+ years of experience in claims coordination,...

Job DescriptionInvestigate and process claims related to lost, damaged, or delayed goods in transit.Gather evidence, such as pre-shipment videos and photos, to support claims.Work closely with WHOps and CCTV team to ensure that the set guidelines are being followed.Collaborate with the Logistics, Payments and Finance team to ensure all RTS Parcels for claims...

About the RoleWe are seeking a skilled Medical Claims and Billing Specialist to join our team at MicroSourcing.This is an exciting opportunity for a detail-oriented professional who enjoys working in a fast-paced environment. As a Medical Claims and Billing Specialist, you will play a critical role in ensuring accurate and timely payment processing for...

Duties and Responsibilities:Claims ProductionReviews claims daily based on medical necessity, coverage guidelines, coding & payment standard and applicable regulatory and compliance requirements.Reviews claims above $25,000 in estimated payments.Reviews services for appropriateness of charges and ensures payments are consistent with authorization information...

COMPANY PROFILE:Trinity is a full-line insurance broker that provides products and services in both General Insurance and Employee Benefits. For more than three decades, Trinity has transformed the lives of its clients and customers, redefining what it means to be in the business of insurance by creating products and services that are customized,...

About the JobWe are seeking an experienced and skilled Insurance Claims Supervisor to join our team at Bonifacio Insurance Broker Corporation. As a key member of our claims department, you will be responsible for ensuring the smooth operation of the claims process.Key Responsibilities:Supervise a team of claims specialists to ensure high standards of...

About the RoleThis position plays a crucial role in ensuring the accuracy and compliance of claims processing, which is essential for maintaining positive relationships with payers and upholding the reputation of the organization.Collaboration and Communication:Work effectively with cross-functional teams, including coding, billing, and customer service...

Job Description: The Claims Specialist will be responsible for reviewing, processing, and settling claims in accordance with company guidelines and procedures. This includes collaborating with coordinators to ensure a smooth flow of information and documentation, maintaining accurate records of all claims, investigating and analyzing claim details, and...

Manage new claims, verifying policy coverage and ensuring timely resolution.Maintain accurate records of all claims activities.Communicate effectively with clients, adjusters, and insurance carriers.Assist clients with claim inquiries and provide excellent customer service.Prepare detailed claim reports.Underwriting SupportPrepare and process new and renewal...

Job Description:We are seeking a skilled Dispute Resolution Expert to join our team at Brightwell. In this role, you will be responsible for investigating and resolving card disputes, as well as executing risk/fraud mitigation operations on a daily basis.You will analyze various anomalous transactional activities, identify and categorize threats and risks,...