We're #hiring a Medical Malpractice #ClaimsAdjuster to work remotely for our client. • Direct Hire | Remote • Up to $129,000/annually #ClaimsJobs #AdjusterJobs #InsuranceJobs #RemoteJobs https://lnkd.in/ezQcRqiK
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"Expert Claims Handler with Proficiency in Medical Underwriting | Healthcare & Insurance Specialist." With nearly 5 years of dedicated service, my journey as a Claims Handler with S3 GLOBAL SOLUTIONS LLP has been nothing short of inspiring. From meticulously analyzing claims to steering complex underwriting decisions - my career has been a testament to my passion for blending analytical prowess with high-quality customer service. What fuels my drive? ✨ A solid grounding in evaluating files, ensuring that every detail is scrutinized for accuracy and compliance. The opportunity to collaborate closely with professionals, enabling informed decision-making that ultimately protects both companies and policyholders. A continuous quest for knowledge, staying abreast of the latest industry practices and innovations to deliver beyond expectations. As I look to the horizon, I'm eager to channel my experiences into a new challenge, specifically as a Claims Handler on a personal injury team. My aim? To not just meet the benchmarks, but to set them, contributing to a culture of excellence and innovation. 📢 I'm on the lookout for opportunities where I can leverage my expertise and make a meaningful impact. Do you know a team I can contribute to? Let's connect! Your insights or a simple share can pave the way for exciting new collaborations. #JobSearch #InsuranceIndustry #ClaimsHandling #ProfessionalGrowth #LetConnect
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DVA is not associated with this job posting Medical Claim Resolution Specialist - Digitech - Remote https://lnkd.in/gzk_sSMs Essential Duties and Responsibilities: Work claims that are pending, are unable to be released or have been denied or incorrectly paid by Insurance carriers. Review claims that have been put on hold, working to identify causes and address issues causing them to remain on hold. Work denials aiming to identify why claims have been denied, and handle follow-up accordingly. Provide insurance companies with additional information as necessary to process a claim correctly and/or send an appeal. Handle all correspondence via mail, email, and any necessary refunds. Performs other duties as assigned by management. #recruiting #nowhiring #hiring #jobs #jobsearch #job #recruitment #careers #recruiting #hiringnow #employment #career #jobseekers #jobopening #work #jobhunt #resume #jobopportunity #applynow #jobsearching #jobseeker #hr #staffing #jobshiring #cfbr #jobinterview #vacancy #recruiter #jobalert #business #joinourteam
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The credentialing process can take several months to complete, depending on the state you live in and the insurance company that you are requesting credentialing with. Here are the major factors that currently affect the process.
Helping Providers Connect with Insurance Companies | Educating Investors and Owners on the Provider Enrollment Process | Credentialing Specialist, Key-Note Speaker, Educator
Why is it taking so long for me to get credentialed? There are so many factors that can affect the credentialing process but let's look at the significant factors at play. 1. During COVID, the insurance companies relaxed their requirements so that providers could quickly be credentialed to serve patients. Now that the COVID crisis is over, the insurance companies are not only returning to pre-COVID standards and requirements, but they have revamped the process to add more requirements. 2. Several insurance companies have lost employees due to strikes, layoffs, and lawsuits, which has resulted in the companies being short-staffed and overwhelmed. 3. Each state and each insurance company has its own standards and requirements. This means that even if BCBS in one state processes an application within a specific timeframe, BCBS in another state might take months. So, there's no guarantee that a credentialing application will be processed in a specific timeframe. However, ensuring that the correct application is sent to the right insurance with the required documents will make the process smoother and quicker. This cuts down delays in correcting mistakes or redoing applications. Stay tuned for the next post on ways to make sure you're doing your part in the credentialing process! Original Article on https://lnkd.in/eXgxk54z #healthcareconsulting #credentialing #providercredentialing #providerenrollment #consulting
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Helping Providers Connect with Insurance Companies | Educating Investors and Owners on the Provider Enrollment Process | Credentialing Specialist, Key-Note Speaker, Educator
Why is it taking so long for me to get credentialed? There are so many factors that can affect the credentialing process but let's look at the significant factors at play. 1. During COVID, the insurance companies relaxed their requirements so that providers could quickly be credentialed to serve patients. Now that the COVID crisis is over, the insurance companies are not only returning to pre-COVID standards and requirements, but they have revamped the process to add more requirements. 2. Several insurance companies have lost employees due to strikes, layoffs, and lawsuits, which has resulted in the companies being short-staffed and overwhelmed. 3. Each state and each insurance company has its own standards and requirements. This means that even if BCBS in one state processes an application within a specific timeframe, BCBS in another state might take months. So, there's no guarantee that a credentialing application will be processed in a specific timeframe. However, ensuring that the correct application is sent to the right insurance with the required documents will make the process smoother and quicker. This cuts down delays in correcting mistakes or redoing applications. Stay tuned for the next post on ways to make sure you're doing your part in the credentialing process! Original Article on https://lnkd.in/eXgxk54z #healthcareconsulting #credentialing #providercredentialing #providerenrollment #consulting
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I am hiring for many Insurance Follow-Up Specialists- $23/hr, W-2, 100% remote positions. FULL TIME M-F 8-4:30 est. **Epic experience is required - 3 years and must be recent** **Must have ACTUE HOSPITAL AND PROFESSIONAL BILLING EXPERIENCE*** Resume must reflect 1. How many years of hands-on appeals experience do you have, including all the investigation required to determine if an appeal is necessary? 2. Explain your active experience in the past three years with – AR, follow up, appeals, underpayments, payor knowledge, research accounts, medical terminology. a. Does your resume reflect these skillset requirements within the last 2 years? (If not please update your resume to reflect this experience) 3. Can you provide an example of your experience with appealing denials? And resubmitting corrected claims? Underpayments? 4. Can you provide an example of a denied claim that you appealed? What steps did you take? (Please provide as much detail as possible) 5. Tell me about your experience in calling insurance companies daily checking status of past due claims? (They should know how to call BC/BS and Cigna as well as other payors to resolve claims.) 6. Tell me about your experience with using websites to check the status of multiple claims with the payors? 7. Tell me about your experience with reading an explanation of benefits? 8. Can you explain what the explanation of benefits provides? 9. Tell me about your experience with understanding medical terminology? Give examples. 10. Validate that you do not have any PTO scheduled during the first 90 days of the project. 11. Tell me about your experience in dealing with Medicare Managed Care and Medicaid Managed Care. 12. What MCO payers are you familiar with? 13. How successful have you been in collecting aged AR? 14. What is your experience with hospital /institutional claims 15. What is your backend (AR/Denials) experience working in Epic and how many years? What job functions do you do inside Epic? How were you assigned daily/weekly work to work these accounts in Epic? All resumes to [email protected] Please share- Thank you- MUST RESIDE IN USA-
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Founder HIM Relevant, IRF & Inpatient Coding & Consulting. RHIT, CCS, AHIMA Approved ICD-10-CM/PCS Trainer
If you’re a Coder, Manager, Health Information professional or an Auditor this is a really important read. I can not over emphasize the importance of anyone involved in Revenue Cycle truly understanding the consequences of fraudulent activity. Health Information professionals require the integrity - regardless of payor requirements, or reimbursement, to absolutely safeguard each and every encounter by only selecting and applying diagnostic codes that are documented and supported by the physician(s). Each Coder took a sort of “oath” that requires ethical behavior at all times when receiving our credentials. I am stunned and disheartened to read the findings in this article. We must do better. We’re a team with our physicians and should work as such. Wow.
When Coding Creativity Turns Criminal
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I am curious about medical claims denial; specifically pre-authorization, not the management of post billing/revenue recover, but simply when a doctor recommends a test or treatment, but the insurance plan will not allow coverage because their team of analysts has reviewed the documentation and overruled the doctor. What is the job title of this? What education and experience (other than the ability to say "no" to everything) is required? Is the person who makes this decision someone with a medical degree who could practice in a clinic? I have heard that health plans simply hire hundreds of people with medical credentials to deny everything they can and then have more experienced people to fight the appeals, but I know that is kind of a "trolling statement" for people who actually do this work and believe they are helping to keep health care costs down by preventing unnecessary billing...so enlighten me :)
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I am interested in connecting with healthcare professionals who have experience in any of the following areas listed below: • Virtual Medical Assistance • Virtual Healthcare Assistance • Credentialing • Medical Billing • Patient Service • Revenue Cycle Management (RCM) • Insurance Verification • Eligibility Checking • Medical Scribing • Medical Transcription • Prior Authorization • Insurance Claim Management • Denial Management • Medical Debt Collection • Accounts Receivable (AR) If you have expertise in any of these areas, please send me a connection request or like this post so I can view your LinkedIn profile. If you think this message would be useful to your network, please share it by reposting. You can also comment 'Cfbr' to help others discover this post.Thank you! #hiringnow #hiringurgently #hiringimmediately #virtualassistant #medical #credentialing #medicalbilling #frontdesk #patientservices #patientbilling #revenuecyclemanagement #insuranceverification #medicalscribing #medicalscribe #medicaltranscription #priorauthorization #insuranceclaims #denialmanagement #claimdenials #medicalbiller #medicalbillingandcoding #medicalbillingspecialist #medicalcoding #medicalcodingjobs #remotejobs #workfromhomejobs #medicalcoder #medicalbillingservices #insurance #ushealthcare #USHealthcare #HealthcareIndustry #HealthcareExperts #MedicalBilling #RevenueCycleManagement #HealthcareManagement #PatientSupport #EligibilityChecking #BenefitsVerification #PriorAuthorization #MedicalBillingExpert #HealthcareServices #InsuranceClaims #PatientCare #HealthcareAdministration #HealthcareProfessionals #HealthcareTech #MedicalCoding #HealthcareSystems #HealthcareAnalytics #HealthcareLeadership #HealthcareInnovation #Health
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#hiring Senior Claims Technical Specialist - Private Company, Chicago, United States, fulltime #jobs #jobseekers #careers #Chicagojobs #Illinoisjobs #InsuranceSuperannuation Apply: https://lnkd.in/gSFr8xmY Primary Details Time Type: Full time Worker Type: Employee The Opportunity This opportunity is accountable for adjusting a select portfolio of claims involving Private Company Management Liability - directors and officers, employment practices, fiduciary liability and crime. The ideal candidate will have extensive experience managing such claims, as well as exceptional coverage and litigation management competencies. Strong organizational and diary/time management skills are also a must. A JD is strongly preferred. Primary Responsibilities Independently manage a diverse portfolio of high severity claims including coordinating an investigation into liability and exposure and review and interpretation of policy language in an effective and efficient manner Evaluation and negotiate the resolution of assigned claims in a timely manner, within appropriate authority and in accordance with laws and best practices Drive the highest level of customer care, responsiveness and satisfaction Deliver favorable claim outcomes Collaborate with outside counsel to formulate litigation strategy ensuring achievement of desired outcome and effective litigation management Effectively communicate internally with relevant stakeholders and externally with counsel and with customers and brokers Analyze, develop and determine appropriate case reserves and identify relevant claims of concern Take ownership for personal development and career planning and maintain understanding of company Required Education Bachelor's Degree or equivalent combination of education and work experience Required Experience 8 years relevant experience Preferred Competencies/Skills • Generate original, innovative solutions to difficult or unusual situations • Identify and locate information and facts which are necessary and relevant for the purposes of evaluating a claim • Financial and business acumen and awareness of financial responsibility • Properly document investigation findings and preserve evidence in accordance with internal and external laws and procedures • Develop effective negotiation strategies and prepare a plan of action • Build and capitalize on beneficial internal and external relationships including competitors • Actively contributes towards continuously improving performance • Build constructive and cooperative working relationships and open lines of communication • Utilize effective communication skills to influence and persuade decision makers • Manage a diverse and extensive portfolio of Professional Liability Program Claims with varying levels of complexity and activity. • Collaborate with internal resources to resolve difficult claims situations and drive reso
https://www.jobsrmine.com/us/illinois/chicago/senior-claims-technical-specialist-private-company/469270580
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🏗️ Avoid the biggest mistake when hiring a contractor🚫 ❌DON’T Hire someone without a valid license and insurance. 🧐Always make sure you check with the State to confirm their credentials, it's as easy as making one simple phone call. ☎️ Why would you take the risk?🤔 #ContractorHiring #LicenseAndInsurance
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