Medical Claim Review Specialist jobs

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CCS Medical Coder (DRG Validation Auditor)
Datametrix Inc 2 reviews - Remote
Screens claim data for appropriate cases for review. Reviews clinical documentation and validate facility codes/APR and MS DRG assignment, discharge disposition...
Sponsored by Datametrix Inc - 30+ days ago
Coder II Practice Dual Skilled
Mission Hospitals - Asheville, NC
Reviews data from the medical record to determine or confirm diagnosis and CPT procedure codes. Links the diagnoses with appropriate CPT code for physician...
Sponsored by Mission Hospitals - 8 days ago

Accounts Receivable/Medical Billing Specialist

Intermedix 54 reviews - Miami, FL
Accounts Receivable Specialist. Medical Billing experience required. Interact with third parties representative and utilize online sites to review status and...

Medical Record Specialist

Datametrix Inc 2 reviews - Salt Lake City, UT 84107
Schedules and coordinates onsite reviews and onsite review medical record request as deemed by service line. Reviews medical records to verify dates of service,...

Claims Audit Specialist - Medical Claims

WellCare 103 reviews - Tampa, FL
Conducts daily quality reviews of operations department processes (i.e. Eligibility, enrollment, claims processing and pricing, configuration contract loads,...

Supervisory Medical Administration Specialist

Department of Veterans Affairs 916 reviews - Charleston, SC
Supervisory Medical Administration Specialist/ #031940. The Supervisory Medical Administration Specialist supports top management responsible for planning,...

Clinical Support Specialist - P09

Moda Health 14 reviews - Portland, OR 97204 (Downtown area)
Completes reviews or support the clinical staff in the review processes by preparing or completing the requests as assigned....

Medical Bill Review- Provider Relations Specialist

Accident Fund Holdings, Inc. - Lansing, MI
One year as a Medical Bill Review Specialist II. Basic knowledge of Claims process including medical reserving procedure....


University of South Florida Health - Tampa, FL
Request and review information such as medical records, EOBs, charge tickets, etc., for account resolution as needed for appeals, insurance requests and...

Medical Only Claim Specialist

The Travelers Companies, Inc. - Walnut Creek, CA
Reviewing/evaluating, approving and processing Medical Only claims with:. Determining causal relatedness and medical necessity of minor medical conditions...

Provider Auditor – CPC Required

Blue Cross Blue Shield of Massachusetts 31 reviews - Quincy, MA
Coordinate claim finding issues with medical, pharmacy, contractual and claims inquiries and provide interpretation of medical policy, contracts and benefits....

Eligibility & Benefit Specialist

Fairview Health Services 35 reviews - Minnesota
Reviews changes implemented through the testing process. Performs individual claim research as well as macro testing analysis....
Claims Specialist I, Medical
Nationwide Mutual Insurance Company 727 reviews - Cleveland, OH
Evaluates and investigates first party medical claims. Office claims environment. Determines applicable coverage, medical necessity and appropriateness of...
Sponsored by Nationwide Mutual Insurance Company - 15 days ago
Medical Management Spec l, ll, or Sr - El Paso MMP 97117
Anthem, Inc. 544 reviews - El Paso, TX
Medical Management Specialist II. Medical Management Specialist I, II, or Sr. Provides mentoring and leadership to other medical management specialists....
Sponsored by Anthem, Inc. - 6 days ago
Medical Billing EDI Specialist
LogixHealth - Bedford, MA
Prepare the electronic claims to be sent. Entry level Specialist position, whose prime focus will be working with insurance carriers to gain website access on...
Sponsored by LogixHealth - 19 days ago

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