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Medical Claims Specialist Jobs in South Carolina

Currently, there are no Medical Claims Specialist jobs available in South Carolina which match this search. You may wish to explore similar job titles on the Healthcare jobs in South Carolina page or view related jobs below.
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Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
JOB SUMMARY: Vacancy Identification Number (VIN): 1612842 OUR MISSION : To fulfill President Lincoln's promise "To care for him who shall have borne the battle, and for his widow, and his orphan" by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? As a VA professional, your opportunities are...
JOB SUMMARY: The Navy and Marine Corps team offers innovative, exciting and meaningful work linking military and civilian talents to achieve our mission and safeguard our freedoms. Department of the Navy provides competitive salaries, comprehensive benefits, and extensive professional development and training. This position is located in the Directorate for Administration, Patient Administratio...
Line of Business Mills Category Safety Location CMC Steel South Carolina 310 New State Rd Cayce, SC 29033 Relocation Assistance No General Description This position exists to assist and support the site safety manager, the department safety coordinators, and facility management in discharging the safety program. The facility has a world class safety program with an IR consistently below...
JOB SUMMARY: The mission of the United States Air Force is to fly, fight and win...in air, space and cyberspace. To achieve that mission, the Air Force has a vision of Global Vigilance, Reach and Power. That vision orbits around three core competencies: Developing Airmen, Technology-to-Warfighting and Integrating Operations. Core competencies and distinctive capabilities are based on a shared comm...
Prestige Staffing needs 3 Account Receivable Specialists who is very familiar with all payers and will be responsible for insuring claims are worked and paid within a specific period of time. This is a contract to hire position. Essential Functions: Set goals with Director and Assistant Director of Patient Accounts, regarding monthly/yearly account receivable expectations. Responsible for audit...
JOB SUMMARY: The mission of the United States Air Force is to fly, fight and win...in air, space and cyberspace. To achieve that mission, the Air Force has a vision of Global Vigilance, Reach and Power. That vision orbits around three core competencies: Developing Airmen, Technology-to-Warfighting and Integrating Operations. Core competencies and distinctive capabilities are based on a shared comm...
JOB SUMMARY: The mission of the United States Air Force is to fly, fight and win...in air, space and cyberspace. To achieve that mission, the Air Force has a vision of Global Vigilance, Reach and Power. That vision orbits around three core competencies: Developing Airmen, Technology-to-Warfighting and Integrating Operations. Core competencies and distinctive capabilities are based on a shared comm...
Benefits Specialist The Benefits Specialist serves an assigned area/region, providing assistance and services to associates related to employee benefits. This includes medical, dental, vision, and life insurance, short-term and long-term disability benefits, the Retirement Savings Program, COBRA continuation of coverage, flexible spending accounts, and health savings accounts. Works with associat...
GED or High School Diploma required Job Summary The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely . Responsibilities will vary based on department need. Duties to include- · Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management researc...
Job Summary Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies as a part of the integrated Healthcare Services Team. Conducts pertinent research, evaluates, responds and completes appeals and other inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal summar...
Job Summary Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies as a part of the integrated Healthcare Services Team. Conducts pertinent research, evaluates, responds and completes appeals and other inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal summar...
JOB SUMMARY: The mission of the United States Air Force is to fly, fight and win...in air, space and cyberspace. To achieve that mission, the Air Force has a vision of Global Vigilance, Reach and Power. That vision orbits around three core competencies: Developing Airmen, Technology-to-Warfighting and Integrating Operations. Core competencies and distinctive capabilities are based on a shared comm...
JOB SUMMARY: The mission of the United States Air Force is to fly, fight and win...in air, space and cyberspace. To achieve that mission, the Air Force has a vision of Global Vigilance, Reach and Power. That vision orbits around three core competencies: Developing Airmen, Technology-to-Warfighting and Integrating Operations. Core competencies and distinctive capabilities are based on a shared comm...
JOB SUMMARY: The mission of the United States Air Force is to fly, fight and win...in air, space and cyberspace. To achieve that mission, the Air Force has a vision of Global Vigilance, Reach and Power. That vision orbits around three core competencies: Developing Airmen, Technology-to-Warfighting and Integrating Operations. Core competencies and distinctive capabilities are based on a shared comm...
Provides excellent customer service in handling subrogation claims. Reviews, analyzes and determines subrogation potential on all assigned files. Must understand coverage, policy interpretation and exposure recognition and liability determination at all levels of the claim. Negotiates liability, settlements and payment arrangements. Develops resolution plans by determining filing solutions (arbit...