10 bill review analyst i jobs found

The Professional Review Analyst analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Candidate must be located in the greater Charlotte, North Carolina Region and able to attend in office training for a minimum of 1 week at start of employment. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical...

Job Description: Providing for loved ones, planning rewarding retirements, saving enough for whatever lies ahead – our policyholders count on us to be there when it matters most. It’s a big ask, but it’s one that we have the power to deliver when we work together. We collaborate and innovate – pushing one another to transform not just Pacific Life, but the entire industry for the better. Why? Because it’s the right thing to do. Pacific Life is more than a job, it’s a career with purpose. It’s a career where you have the support, balance, and resources to make a positive impact on the future – including your own.​ Performs bank reconciliation activities, including the preparation, maintenance, and reconciliation of bank accounts and related general ledger accounts. Responsible for reconciling cash activity between bank statements and the general ledger, identifying, researching, and resolving reconciling items such as timing differences, errors, and unusual transactions....

Staff Software Engineer - IE07IE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.              The Hartford is searching for a Staff Software Engineer within the Personal Lines organization that will have end-to-end technical accountabilities in application development for personal lines portfolio in a highly distributed, integrated, multi-platform environment. This team is passionate for technology and strives to build well architected and innovative solutions for the business as well as Fundamentally treats IT Operations as Software Engineering and adopted Scrum development methodology and core agile engineering practices such as continuous integration and test-driven development. Responsibilities: Technical Leadership:...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Bridge Specialty Group is seeking a Sales Leader to join our growing tea m in Charlotte, NC!          The Sales Leader m anages a personal book of business while driving top-line revenue growth through strategic oversight of the pro duction tea m , mentorship and development of current tea m members, and recruitment of high-potential sales talent to support long-term success. This position requires a balanced blend of direct sales execution, operational leadership, tea m development, and talent acquisition to maximize overall office performance. In addition to leading sales initiatives, the Sales Leader is responsible for expanding customer relationships by leveraging the company’s full suite of capabilities, pro moting cross-selling opportunities, and deepening...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

Manager Software Engineering - IE07FE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.              The Hartford’s Group Benefits IT Team is seeking a highly motivated, experienced IT Leader who is responsible for leading engineering teams to successfully drive the transformation of our application landscape.  The Software Engineering Manager will have end-to-end accountabilities in IT Operations across the application portfolio.   Successful candidates will be expected to demonstrate strong leadership skills, excellent partnership with stakeholders and partner teams, solid technical acumen, experience in delivering quality technical solutions as well as setting and executing on a strategic technical vision to ensure the systems are...

The Auto and General Liability Claims Specialist manages within company best practices lower-level, non-complex and non-problematic liability claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Commercial Auto & General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Requires regular and consistent attendance Additional...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Bridge Specialty Group is seeking a Sales Leader to join our growing tea m in Charlotte, NC!          The Sales Leader m anages a personal book of business while driving top-line revenue growth through strategic oversight of the pro duction tea m , mentorship and development of current tea m members, and recruitment of high-potential sales talent to support long-term success. This position requires a balanced blend of direct sales execution, operational leadership, tea m development, and talent acquisition to maximize overall office performance. In addition to leading sales initiatives, the Sales Leader is responsible for expanding customer relationships by leveraging the company’s full suite of capabilities, pro moting cross-selling opportunities, and deepening...