to determine if review by clinician is required Analyze and reprice claim for setting up of re-adjudication Communicate... original claims processing details. You'll also need to effectively draft correspondence that explains the claim resolution...
, expertise and judgment Investigate claim and/or customer service issues as identified and communicate resolution to customers... and provides information privacy. Must live in a location that can receive a UnitedHealth Group approved high-speed internet...
with a diverse group of passionate individuals to deliver sustainable solutions to advance mobility, improve wellbeing, and enhance..., including notices, letters, forms, and claim packets. Perform daily processing and data reconciliation between Workday...
: Works daily reports from member notes and claim notes to verify, clarify, and update member eligibility. Looks up member..., within 1 day of receipt of claim by the production area. If eligibility is verified with one of our groups accurately updates...
of restitution responsibilities. Provides group educational sessions in cognitive skills to help develop pro-social behaviors... government based on the veteran's military service, and wish to claim veterans' preference, please attach the appropriate...
together — and we’re the kind of group that’s friends outside of the office, too. The atmosphere here is laid back and positive... database. Assist customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim...
of claim reserves Demonstrates proficient knowledge regarding theories of liability and State specific negligence standards... Accurately document claim files with all relevant correspondence, documentation, and file notes Demonstrates proficient...
Collections) and billing processes to assist with a clean claim rate. Responsible for accurately screening of medical necessity... Group's RCM Operations PEAK Matrix Assessment 2024 Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards...
and corrects the CMS 1500 claim form using proper data elements for each payer, ensuring correct billing units, dates of service... objective of maximizing reimbursement to MercyOne North Iowa Home Medical Equipment and ensuring the claim is paid/settled...
also handles escalated claim inquiries from internal business partners, claim appeals, and privacy incident research..., and documentation. In addition to claims responsibilities, this position manages billing and reconciliation of claim payments...