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Claims manager [h1.location_city]

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Claims manager • washington dc

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  • [promoted]
Claims Specialist

Claims Specialist

Healthcare Legal Solutions LLCWashington, DC, US
[job_card.full_time]
This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents. researching using hospital and insuran...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Resolution Analyst

Claims Resolution Analyst

Magellan HealthWashington, DC, US
[job_card.full_time]
Claims Internal Resolution Analyst.The Claims Internal Resolution Analyst is responsible for coordinating the resolution of claims issues locally at the health plan by actively researching and anal...[show_more][last_updated.last_updated_1_day]
  • [promoted]
Technical Claims Manager Direct [2]

Technical Claims Manager Direct [2]

CompreWashington, DC, US
[job_card.full_time]
Technical Claims Manager Direct.Technical Claims Manager Direct US Hybrid, two days in office / remote East Coast (preferred) Full-Time We are a fast-growing global reinsurance speciality company...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Analyst / Lead Claims Analyst / Senior Claims Analyst (Full-Time)

Claims Analyst / Lead Claims Analyst / Senior Claims Analyst (Full-Time)

McDonough Bolyard PeckWashington, DC, US
[job_card.full_time]
Claims Analyst / Lead Claims Analyst / Senior Claims Analyst.MBP is looking for Claims Analyst / Lead Claims Analyst / Senior Claims Analyst in Tampa, FL, Raleigh, NC, or Washington DC areas, with signific...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Adjuster, Subrogation

Claims Adjuster, Subrogation

Pie InsuranceWashington, DC, US
[job_card.full_time]
Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie.We leverage technology to transform how small businesses buy and experience comme...[show_more][last_updated.last_updated_30]
Claims Resolution Specialist

Claims Resolution Specialist

Vets HiredArlington County, Virginia, USA
[job_card.full_time]
The Claims Resolution Specialist is responsible for ensuring accurate and timely billing and reimbursement for medical services. This role requires strong knowledge of medical terminology coding ins...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Claims Manager

Claims Manager

Crossroads Talent SolutionsWashington, DC, US
[job_card.full_time]
DMAVR Claims Manager (Support Coordinator).The DMAVR Claims Manager manages claims under the Defined Monetary Assistance Victims Reserve (DMAVR) program. This role involves reviewing, processing, an...[show_more][last_updated.last_updated_variable_days]
Claims Manager

Claims Manager

GT IndependenceSilver Spring, MD , US
[job_card.full_time]
Work for a company where you make a difference in people's lives every day!.At GT, we know that our people are at the heart of our success. If you love your work, enjoy collaboration, and want to le...[show_more][last_updated.last_updated_30]
  • [promoted]
Medical Claims Processor

Medical Claims Processor

Pyramid ConsultingWashington, DC, US
[job_card.temporary]
Immediate need for a talented Medical Claims Processor.This is a 04+ months contract opportunity with long-term potential and is located in Denver, CO (Remote). Employee benefits include, but are no...[show_more][last_updated.last_updated_30]
  • [promoted]
Contracts and Claims Manager

Contracts and Claims Manager

Luster NationalWashington, DC, US
[job_card.full_time]
We're seeking Contracts And Claims Managers to support large, heavy-civil infrastructure programsincluding highways, roads, bridges, transit (including rail and bus), and airport projects delivered...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Claims Analyst

Claims Analyst

The Midtown GroupWashington, DC, US
[job_card.full_time]
At least twenty-four (24) Medicaid related Claims Analyst and Claims Processors are needed for a long-term project in DC. These positions are 100% onsite and located downtown, near Farragut North Me...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Claims Analyst

Claims Analyst

Edenbridge Health LlcWashington, DC, US
[job_card.full_time]
Organization : Edenbridge PACE at Skyland.Mission : To allow frail elderly people to age in the location of their choosing and continue to lead connected, meaningful lives. The Claims Analyst reviews,...[show_more][last_updated.last_updated_30]
Claims Analyst / Lead Claims Analyst / Senior Claims Analyst (Full-Time)

Claims Analyst / Lead Claims Analyst / Senior Claims Analyst (Full-Time)

Mc Donough Bolyard PeckWashington, DC, United States
[job_card.full_time]
Claims Analyst / Lead Claims Analyst / Senior Claims Analyst.MBP is looking for Claims Analyst / Lead Claims Analyst / Senior Claims Analyst in Tampa, FL, Raleigh, NC, or Washington DC areas, with signific...[show_more][last_updated.last_updated_30]
Claims Manager

Claims Manager

VirtualVocationsWashington, District of Columbia, United States
[job_card.full_time]
A company is looking for a Claims Manager responsible for overseeing claims adjusters and ensuring efficient claims processing. Key Responsibilities Manage claims adjusters to ensure timely handli...[show_more][last_updated.last_updated_30]
  • [promoted]
Analyst, Claims Research

Analyst, Claims Research

Utah StaffingWashington, DC, US
[job_card.full_time]
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing ...[show_more][last_updated.last_updated_variable_days]
Senior Manager, Specialty Claims - Employment

Senior Manager, Specialty Claims - Employment

Marriott InternationalBethesda, MD, United States
[job_card.full_time]
The Senior Manager, Specialty Claims is primarily responsible for overseeing and managing claims covered under Marriott International’s global Employment Practices Liability (EPL) and Fidelity insu...[show_more][last_updated.last_updated_30]
Claims Specialist

Claims Specialist

Healthcare Legal Solutions LLCWashington, DC, US
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Job Description

Job Description

SUMMARY :

This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.

DUTIES AND RESPONSIBILITIES :

  • Investigates Claims Denials.
  • Handles large volumes of documents, including accurately scanning and mailing documents.
  • Utilizes increased knowledge of the industry, hospital revenue cycle, and payers / insurance companies to document the account and provide information and details to support paralegal’s / attorney’s pursuit for additional reimbursement.
  • Works within the client’s Patient Accounting system, payer portals and / or websites, and will utilize proprietary software to research accounts in the work queue.
  • Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
  • Opens, sorts, and imports incoming correspondence into the office database.
  • Navigates through various computer systems and applications to find information about insurance claims.
  • Greets and assists onsite guests.
  • Answers calls for Claim status and Appeal status.
  • Performs any other administrative duties as may be necessary.
  • Performs other related duties as assigned by management.

QUALIFICATIONS :

  • Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and / or training, or equivalent combination of education and experience.
  • Other skills required :

    • Previous experience in office administration or another related field.

  • Basic working knowledge of the US healthcare system.
  • Ability to prioritize and multitask.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office, including Word and Excel.
  • Highly attentive to detail.
  • Excellent organizational and time management skills.
  • Clear, concise, and logical writing style.
  • Computer-savvy, able to learn new applications / software quickly.

    • Please remove paragraph before using in Workplace

    COMPETENCIES : Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each job description. Then select an additional 3-5 of the most critical competencies for the specific job title.

    Please note : You may remove complete statements and complete sub-title sections however the verbiage / content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.

    COMPETENCIES :

  • Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
  • Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
  • Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
  • Business Necessity – The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
  • Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
  • Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
  • Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
  • Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
  • Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
  • Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
  • Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
  • Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
  • Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
  • Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
  • Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.