Claims Jobs in Fairfield
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Fairfieldicims.com
Overview:
To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Completes and processes claims and claims worksheets. Creates appropriate documentation...
AdaptHealth LLC CareersFairfieldmindmatch.ai
an accredited college required, bachelor’s degree preferred
Five (5) years’ experience in the HME leadership is required
Relevant experience in health care, insurance customer services, claims, billing is preferred
Valid and unrestricted driver’s license...
Fairfieldicims.com
Overview:
To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Creates appropriate documentation that reflects the actions taken and status...
WALGREENSLittle Rock, 1661 mi from Fairfield
documentation, training, inventory management, and POS registers).
• Processes insurance claims. Liaises with insurance companies, medical providers and auditors.
• Develops and maintains relationships with the local medical community, including physicians...
Fairfieldicims.com
Overview:
To support the Claims Department in maintaining pended claims, corrected claim inquiries and claims adjustment projects within established guidelines. Reviews and processes complex claims, supports claims examining, while offering...
Fairfieldicims.com
benefit designs and ensure successful configuration, integration, and accurate and timely payment of claims and all Partnership systems. Coordinates testing, quality assurance, configuration, installation, and support to ensure smooth, stable and timely...
Fairfieldicims.com
systems, processes, and methodologies to ensure effective monitoring, control, and support of service delivery.
• Creates and maintains functional and technical documentation.
• Develops and maintains in-depth knowledge of the Claims Core System...
Fairfieldicims.com
integrity of HIE / EDI/ Claims System databases and the accuracy of reporting data.
• Represent Web Applications team in data quality meetings
• Leads and participates in special projects as needed and assigned.
Qualifications:
Education and Experience...
Fairfieldicims.com
unique agreements including memorandums of understanding (MOU) and/or letters of agreement (LOA) with healthcare providers. Use Partnership routing system to notify Claims and Health Service departments.
• Effectively communicate Partnership’s mission...
Fairfieldicims.com
Collaborates with department leaders (Member Services, Health Services, Claims, PR, Admin) to gather and define telecom-related business requirements.
• Partners with IT leadership to align telecom strategy with broader digital transformation and customer...
Fairfieldicims.com
Responsibilities:
• Conducts retrospective claims review, either in the aggregate or on an individual basis. Provides summaries of findings to the Team Manager UM.
• Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi...
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