The Claims Examiner is detail oriented and will be responsible for reviewing and adjudicating health insurance claims for all products and all lines of business, including but limited to Medicare, Self Funded, Fully Insured, ensuring accuracy compliance with policies and regulations and timely settlements. This role involves assessing claims, verifying information, and co

This position is accountable for the billing and collections of Renown healthcare claims, ensuring timely and accurate claim submission, maximizing reimbursement for those services rendered in order to maintain a consistent cash flow. Nature and Scope The Insurance and Claims Representative is responsible for Accuracy and completeness of patient accounts for billing and f

The Manager of Medicare Enrollment is responsible for managing the day to day operations of the Prominence Medicare Enrollment team. The manager will support staff to ensure the enrollment process is in compliance according to CMS rules and regulations, accurate and timely. The Manager will develop and/or implement policies and procedures and analyze processes for improve

Drive implementation and consistent utilization of loss mitigation initiatives and practices. Review and investigate claims, assess losses and damages, and determine liability. Negotiate and process settlements and denials within assigned authority limits and in accordance with applicable policies, tariffs, contracts, bills of lading, and local regulations and conventions