Claims Review Specialist jobs in Bethlehem, PA

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Claims Specialist II, Workers Comp
Manages litigated claim issues in accordance with Best Claims Practices. Documents significant activity and decision in each claim via on-line claim system....
Appeals Specialist - Healthcare
West Corporation - 1,970 reviews - Plymouth Meeting, PA
Understanding of health plan authorizations, including medical policy and claims payment guidelines to evaluate if appeals require clinical or administrative...
RN Case Manager I (Bethlehem, PA or Plano, TX)
Reviews and analysis of disability and critical illness claims. NCM 1 reviews and assesses long and short term disability claims in order to....

Denial Specialist – Clinical Appeals

Lehigh Valley Health Network - 153 reviews - Allentown, PA
Reporting to Manager, Clinical Appeals & Denial Management, denials specialist functions as a hospital liason with external third-party payors to review...

Supervisor of Clinical Appeals & Denial Management

Lehigh Valley Health Network - 153 reviews - Allentown, PA
5 years clinical, utilization review, and case management experience required. Provides support and direction to Appeals Nurses and Appeals & Denial Specialist...

Denial Specialist – Clincal Appeals

Lehigh Valley Health Network - 153 reviews - Allentown, PA
Reporting to Manager, Clinical Appeals & Denial Management, denials specialist functions as a hospital liason with external third-party payors to review...

Utilization Review Coordinator

The MENTOR Network - Bethlehem, PA
UR Coordinator/BHRS Specialist primary duties; Conduct QA reviews on weekly revenue reports. Review Promise eligibility of assigned BHRS consumers weekly....

Billing Specialist

Omnicare, Inc - 810 reviews - Allentown, PA
Prescription third party claims management experience. Review private pay billing statements for correctness and accuracy of charges....

Credit & Collections Specialist

Buzzi Unicem USA, Inc. - Bethlehem, PA
Review aging reports regularly with Sales and monthly with Management. Successfully resolve all open items while keeping management apprised of risk exposure on...

SERVICE CENTER CLERICAL SUPPORT-PT

Ward Trucking - 36 reviews - Easton, PA 18042
Reviews daily PCIR report and clears or reviews service center failures. Daily reviews the “late shipment” and “clears” accordingly....

Project Controls Specialist

Jarvis Walker - Allentown, PA
This includes the analysis of costs related to open contract items such as claims for out-of-scope work billed by contractors....

Certified Coder

Easton Clinic - Easton, PA
Reviews, verifies coding accuracy, codes, abstracts, and coordinates erroneous coding. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS-P)...

Claims Specialist II, Workers Comp

Nationwide Mutual Insurance Company - 1,014 reviews - Harleysville, PA
Manages litigated claim issues in accordance with Best Claims Practices. Documents significant activity and decision in each claim via on-line claim system....
Account Service Manager
Thoroughly reviews inquiry,. Review service expectations and. Reviews pending work items and rigorously pursues....
Bodily Injury Claims Adjuster Resolution Specialist - Blue B...
Liberty Mutual - 1,088 reviews - Blue Bell, PA
$53,700 - $92,900 a year
Bodily Injury Claims Adjuster Resolution Specialist - Blue Bell, PA. Assess actual damages associated with claims and conduct negotiations to settle claims....

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