Claims Jobs in Cleveland
Sr. Workers Compensation Claims Adjuster - Remote - Sacramento, CA
Candidates must reside in California
Are you seeking a career where you can better assist people and help support a strong team? A well-established TPA needs your help to support...
As a Commercial Auto...
- Superior knowledge and understanding of auto body repair techniques, terminology, and vehicle construction.
- Strong understanding of the insurance policies offered by the company.
- Strong understanding of MA unfair claims practices...
Requirements:
Experience and Education- Bachelor's Degree in safety or related field and/or a minimum of 5 years' experience in an EH&S role and a minimum of 1 year experience in ESG.
- Working knowledge of OSHA regulations is required, including claims...
discipline, or in another relevant field
- Possesses at least 6+ years recent experience with Medicare and/or Medicaid Part A, B, & DME claims, coding, and reimbursement procedures, service and coverage policies, coordination of benefits, as well as provider...
in TRC Roll Outs
CORE RESPONSIBILITY- Research customer’s business activity via websites to correctly evaluate exemption claims
- Research state websites to correctly evaluate exemption claims
- Manually create National Account...
and negotiating of construction contracts and engineering agreements. This practice group also assists with managing the construction projects and facilitating any claims stemming from same (though this individual will be transactional focused).
If you have...
cancellations and Denied claims are covered!...
Consistently audits records for appropriate billing. Identifies the correct procedure code is supported by diagnosis code.
Accurately edits claims for modifiers...
- Get signoff from customers on new implementations.
- Proficient with insurance industry standards and best practices, including policy lifecycle, underwriting, rating, and claims processes.
- Strong analytical...
code.Accurately edits claims for modifiers in compliance with CMS, AMA, and CPT coding guidelines.Coordinates coding audits and addendums with registration staff for accurate and complete billing.Prepare patient(s) for and assist with examination...
Health/Vision/Dental Insurance
401K
Up to a $500 Employee Referral Bonus
Thursday, June 13th, 202312:00pm to 4:00pm
Cleveland International Airport
5300 Riverside Dr, Cleveland, OH, 44135
At the baggage claim level at the Aero Cafe
(click here...
functions, when not performing radiological examinations.Consistently audits records for appropriate billing. Identifies the correct procedure code is supported by diagnosis code.Accurately edits claims for modifiers in compliance with CMS, AMA, and CPT...
Contract review as necessary; provide recommendations
Claims handling
Process Audits
Follow up on activities daily
Follow up on cancellations
Finance Agreements
Prepare premium allocations
Policy changes
Stay informed about industry developments...
The main goal of the program is to ensure that billing and coding practices are compliant and accurate, reducing the risk of claim denials and improving financial performance.
Assist with managing external vendor(s).
Certifications needed:
CCS – IP...