Mail processing • allen tx
Summary Of Position: Under the guidance and direction of the Team Leader (Claims Supervisor), the primary role of a Senior Claims Examiner is that of a superior claims processor with a thorough kno... Show more
As a Mail Clerk, you will be responsible for managing mailroom operations and shipping tasks, including: sort and distribute incoming mail.Duties and responsibilities can change depending on busine... Show more
This role is intended for Vietnamese fluent speakers, including reading and writing proficiency.Are you ready to go uP? We are named in Top Workplaces NYC for 2021, 2024, and 2026!.We are one of th... Show more
Marketing Execution Associate Enterprise Engagement Marketing.Chase for Business helps business owners start, grow, and manage their businesses.We aim to be their partner, connecting them to solut... Show more
Marketing Execution Associate Enterprise Engagement Marketing.Chase for Business helps business owners start, grow, and manage their businesses.We aim to be their partner, connecting them to solut... Show more
Immediate need for a talented Financial Analyst.This is a 12 months contract opportunity with long-term potential and is located in Plano, TX (Onsite).Finance-focused role supporting multiple funct... Show more
B&B Trucking is committed to offering our drivers the best working environment with more home time, dedicated runs and a consistent schedule.We are a family run business and know that you value the... Show more
This role is intended for Spanish/Vietnamese fluent speakers.We are named in Top Workplaces NYC for 2024.We are one of the winners of USPAACC's Fast 100 Asian American Business awards.We are recogn... Show more
Business Development Agent Virtual Job Duties: Rigorously prospect for new business and follow up with leads in your pipeline Prima... Show more
Are you a detail-oriented individual looking for an exciting 2nd-shift quality assurance role with growth potential? We are seeking a dedicated Quality Assurance Specialist to join our dynamic prin... Show more
CIVIE was founded in 2018 to tackle the toughest radiology challenges with advanced and evolving technologies.Designed by a team with deep radiology industry experience, CIVIE is driven by our pass... Show more
Unlock your potential with Avenue5 Residential.We take care of you, so you can take care of our residents, properties and clients.Property management may be our business, but people are our passion... Show more
Position Summary: The Senior Account Manager position maintains a professional relationship with our clients through exceptional customer service.Senior Account Managers are assigned a book of busi... Show more
At The Outlook at Windhaven, hospitality is more than a service—it is the foundation of how we care for one another.Our luxury senior living community in Plano, TX, is dedicated to creating an envi... Show more
If you have a passion for helping others and enjoy interacting with the general public, FYZICAL, the leading physical therapy company in the country, has a Customer Service Representative/Pt Aide o... Show more
Loan Officer (Hybrid, In Office Up To 3x Per Week).Serve the American Dream Through Attainable Home Ownership.Help Us Keep Up With Our Growth!.We are looking for licensed mortgage loan officers wit... Show more
The Sterile Processing Technician 2 performs a variety of duties associated with cleaning, sterilization, processing, organizing and distributing patient equipment, instruments, supplies and produc... Show more
Now is a great time to join our growing company! The Millennium Group (TMG) is an award-winning business process outsourcing firm focused on print, mail, document scanning, reception, and related o... Show more
Noelle Ibrahim, PE, VRX is a woman-owned professional services firm certified as a WBE and HUB.We provide turnkey services to the public and private sectors.Our specialties include client-focused p... Show more
The average salary range is between $ 29,129 and $ 42,203 year , with the average salary hovering around $ 33,150 year .
Summary Of Position: Under the guidance and direction of the Team Leader (Claims Supervisor), the primary role of a Senior Claims Examiner is that of a superior claims processor with a thorough knowledge of all claims processing systems, claim processing rules and medical policy. The successful candidate will also possess analytical skills to aid in research and resolution of Adjustment inquiries and/or correspondences. The incumbent will also possess a cooperative spirit that will lead to information sharing with the goal of enhancing the overall performance of the Department.
Major Duties And Responsibilities: Proficient in the use of all claim related systems, including Claims Processing System, Claims Workflow, Claims Pricing system, Claims processing rules and Desk Level procedures. Interpret and apply applicable processing guidelines while interacting with on-line system edits/pends. Research written and/or verbal queries from providers/members/internal departments to determine appropriate action on claim and process corrections as required. Analyze patient and medical information to identify instances where investigation for determining appropriate Claim Benefits, Pricing, Prior Authorization or Coordination of Benefits is necessary and process claims accordingly. Adjudicate all claim types, including professional and facility for all lines of business. Process voids and adjustments as required. Meet and maintain individual and departmental productivity and quality standards. Review and release high dollar claims or other complex claims adjudicated by less senior examiners as directed by the Team Leader (Claims Supervisor). Review reports and research pended claims to ensure timely adjudication within accepted corporate cycle times. Reports include, but are not limited to, daily hot and pend reports, weekly cumulative pend, and other special reports as received from customer. Identify, based on review and research of pend reports, and inform.
Job Location: USTXPAOC01 Plano - TX USA, CLT Alternate.
){kind=logo}
