LogoFresh Jobs Ahead
Arkansas Blue Cross and Blue Shield
Arkansas Blue Cross and Blue Shield
1 001 – 5 000 Xodimlar
Sog‘liqni saqlashSug‘urtaTibbiy sug‘urta

Arkansas Blue Cross and Blue Shield Arkanzas shtatining barcha 75 okrugida tibbiy sug‘urta xizmatlarini taqdim etuvchi Blue Cross and Blue Shield Association uyushmasining mustaqil litsenziatidir. Kompaniya jismoniy shaxslar va oilalar uchun sug‘urta, Medicare va Medigap rejalari, stomatologik va ko‘rish qobiliyatini sug‘urtalash, sayohat tibbiy sug‘urtasi rejalari hamda ish beruvchi homiyligidagi guruh sug‘urtasini taklif etadi.

Kompaniya, shuningdek, sog‘liqni saqlash rejalarini boshqarish, da’volarni ko‘rib chiqish, tibbiy xizmat ko‘rsatuvchilarni topish va davolanish xarajatlarini hisoblash vositalarini birlashtiruvchi Blueprint Portal orqali a’zolarni qo‘llab-quvvatlaydi. Uning faoliyati tibbiy sug‘urta xizmatlari, a’zolarni qo‘llab-quvvatlash va sog‘liqni saqlash rejalarini raqamli boshqarishni qamrab oladi.

LinkedIn
Kompaniyadagi ish o‘rinlari

Remote Claims Specialist at Arkansas Blue Cross and Blue Shield

Process and resolve medical claims that require manual adjudication for Arkansas Blue Cross and Blue Shield. Investigate processing issues, interpret benefits, verify eligibility, and maintain accurate claim decisions.

USAmerika Qo‘shma Shtatlari
19 $ – 25 $ / soat
MasofaviyTo‘liq stavkaJuniorDiplom talab qilinmaydiTalab Qilinadigan Til: inglizchaSug‘urta da’volari bo‘yicha mutaxassis

Tavsif

  • Manually resolve medical claims that the automated processing system cannot adjudicate
  • Investigate claim issues and communicate with relevant parties to collect missing information
  • Record claim details accurately in the claims processing system
  • Interpret contract provisions and applicable benefits
  • Resolve claims edits and audit findings
  • Assess whether services and claims meet benefit eligibility requirements
  • Research processing problems using system resources and official manuals
  • Refer claims to the appropriate internal teams
  • Coordinate with internal employees and medical providers
  • Prepare and issue claim-related correspondence
  • Complete information-request forms as needed
  • Participate in initial training, on-the-job instruction, and continuing education
  • Use applicable computer systems and screens to process claims accurately
  • Keep current with procedural, benefit, and system changes
  • Meet corporate and national MTM productivity and quality standards
  • Use corporate and professional reference materials, including processing manuals and ICD, CPT, and HCPCS codebooks
  • Handle additional duties as assigned

Talablar

  • High school diploma or equivalent
  • At least two years of college coursework, totaling 48 semester hours, or equivalent certification focused on anatomy, medical terminology, mathematics, biology, or a related discipline; alternatively, at least one year of related office experience in claims processing, health insurance, or a medical office
  • Successful completion of the company Claims Assessment proficiency test
  • Effective oral and written communication
  • Strong interpersonal abilities
  • Sound professional judgment
  • Effective decision-making
  • Careful attention to detail
  • Ability to work collaboratively
  • Reliable and dependable work habits
  • Ability to protect the security and confidentiality of records and information
  • Compliance with segregation-of-duties requirements in the Administrative Manual

O‘xshash ish o‘rinlari

Roche

Senior Director of Data Management, Analytical Data Science Solutions

Roche
H1B vizasi homiysiKonsaltingOziq-ovqat va ichimliklarSog‘liqni saqlash
USAmerika Qo‘shma ShtatlariCAKaliforniyaMAMassachusets
182 600 $ – 339 200 $ / yil
OfisdaTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaMa’lumotlar olimi
BulutMikroservislar

Lead Roche’s clinical biometrics data platforms and AI solutions, shaping cloud based pipelines and their integration into clinical workflows. Oversee compliant delivery of clinical data and analytics for healthcare development.

Ochish
Lanlink Informática Ltda.

Server Operating Systems and Virtualization Administrator

Lanlink Informática Ltda.
501 – 1 000 Xodimlar
ITKiberxavfsizlikSun’iy intellekt
BRBraziliyaOfisdaTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: portugalchaMa'muriyat
LinuxVMware

Administer VMware virtualization environments, virtual machines, and enterprise operating systems at Brazilian technology company Lanlink. This onsite role also covers Tier 3 infrastructure support, monitoring, and operational documentation.

Ochish
Ensemble Health Partners

Onsite Financial Counselor — Charleston, SC

Ensemble Health Partners
5 001 – 10 000 Xodimlar
KonsaltingLogistikaSug‘urta
USAmerika Qo‘shma ShtatlariSCJanubiy Karolina
18 $ – 19 $ / soat
OfisdaTo‘liq stavkaJuniorDiplom talab qilinmaydiTalab Qilinadigan Til: inglizchaMaslahatchi

Support hospital admissions by estimating and collecting patient balances, verifying insurance, and assisting with financial assistance and account follow-up. The role also handles cashiering, registration paperwork, and coordination with care teams.

Ochish
Geisinger

Licensed Professional Counselor, Adult Outpatient — Pennsylvania Remote

Geisinger
H1B vizasi homiysiFarmatsevtika mahsulotlariFarovonlikSog‘liqni saqlash
USAmerika Qo‘shma ShtatlariPAPensilvaniyaMasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaMaslahatchi

Provide psychotherapy to Geisinger patients in its adult outpatient program, including individual, family, couples, and group sessions. Develop treatment plans and coordinate triage and crisis response with clinical teams.

Ochish