Sentences with phrase «reviewed claim denials»

* Reviewed claim denials for coding errors, discrepancies, and other problems.

Reviewed claim denials and payer requirements for corrective action and prevention in the future.

Not exact matches

When you see an online renters insurance review complaining about slow payment or denial of a claim, consider that each insurer has a threshold below which claims without prima facie evidence of fraud are paid without anything more than a verbal or written statement of loss from the insured.

John L. Smith, a columnist for the Las Vegas Review - Journal, delivered a sarcastic salvo at the scientific meeting on Tuesday morning, claiming that it is a «climate change denial» event.

When a lawyer reviews a workers» compensation claim in a free consultation, the injured worker will learn the best way to file the claim to avoid missteps that could cost benefits due to errors or denial of a claim.

Claim applications are reviewed by the Society's Lawyers» Fund for Client Compensation Fund Committee, which makes recommendations to Council for approval or denial of a cClaim applications are reviewed by the Society's Lawyers» Fund for Client Compensation Fund Committee, which makes recommendations to Council for approval or denial of a claimclaim.

I highlight this dispute only to show that there is a strong «real world» justification for Article III review of important Executive Branch decisions like the denial of Social Security disability claims.

Main findings from the review of caselaw on WSIB adjudication (see also Chart) point to the regular disregard of the treating health professional's medical opinion about whether return to work is safe; the reversal of benefits promised to the most vulnerable injured workers (those with permanent disabilities approaching «lock - in» of benefits); wrongful denial of compensation based on «little or no evidence» of pre-existing conditions; and undue targeting of workers with psychological injuries for denial of claims and for surveillance.

The auto insurance company reviews your medical history, discovers your pre-existing condition, and issues an insurance claim denial for any benefits relating to your shoulder.

When you see an online renters insurance review complaining about slow payment or denial of a claim, consider that each insurer has a threshold below which claims without prima facie evidence of fraud are paid without anything more than a verbal or written statement of loss from the insured.

However, as noted by Computer Business Review, 26 percent also claimed risks are posed by accepting cryptocurrencies that are commonly used as ransom payments, and 80 percent also noted their awareness of the increased risk for DDoS (distributed denial - of - service) attacks.

Ajilon, Duluth, MN 1/2007 to 5/2011 Medical Biller • Collected information about delinquent accounts and contacted customers to provide them with information on how to pay them back • Reviewed patients» bills for accuracy and attempted to collect missing information • Followed up on unpaid claims with insurance companies and determined reasons for non-payment • Determined reasons for denied claims by interviewing insurance company representatives over the telephone • Checked insurance payments to ensure that they are in compliance with contract discounts • Handled discrepancies in payments by investigating causes and making allowances for mistakes • Respond to patients» information regarding billing services and denials

A Claims representative position primarily deals with investigating the claim made by clients by following specific claims procedures logically such as, prudently reviewing details and facts, interviewing the person of interest and then making a decision based upon the approval and denial of a specific case for further in - depth assesClaims representative position primarily deals with investigating the claim made by clients by following specific claims procedures logically such as, prudently reviewing details and facts, interviewing the person of interest and then making a decision based upon the approval and denial of a specific case for further in - depth assesclaims procedures logically such as, prudently reviewing details and facts, interviewing the person of interest and then making a decision based upon the approval and denial of a specific case for further in - depth assessment.

• Working knowledge of ICD - 9 and ICD - 10 and OASIS • Excellent skills in reviewing delinquent accounts and creating avenues for overdue payments • Demonstrated expertise in translating medical procedures into codes that can be easily translated by payers and medical facilities • Proficient in appropriately and confidentially handling patient treatment, diagnosis and procedural information • Well - versed in investigating rejected claims and ensuring that they are resubmitted and paid • Special talent for investigating insurance fraud and determining ways to counter / avoid sticky situations • Skilled in verifying and completing charge information in company defined databases • Familiar with documentation needs (and manners of obtaining them) for insurance claims submission and approval • Qualified to work efficiently with external collection agencies to ensure maximization of reimbursement • Particularly effective in handling appeals for denials by employing exceptional knowledge of carriers and appeal processes • Special talent for increasing reimbursements by investigating denied claims and providing alternatives to denials

> Captures patient care data for the initial claim preparation > Registration of all patients, including insurance verification > Responsible for accurate and timely preparation of billing data > Validates all appropriate coding data for daily processing > Prepares electronic claims for submission to the appropriate payer > Obtains and submits copies of medical documentation as required or requested by third party payers > Reconciles insurance / patient payments > Assists in deposit preparation > Analyzes and resolves claim rejections and denials related to billing or provider issues > Assists in the compilation of monthly reports > Prepares, reviews, and completes patient statements submissions > Answers patient questions, identifies and resolves patient billing complaints > Assists in delinquent account review > Other duties as requested by the Billing Manager

Will review claims and denials, analyze data, perform adjustments.

Maxim Healthcare Services 08/2007 — 01/2008 Reimbursement Representative • Reviewed unpaid accounts to ensure proper payment and accounting • Contacted payers regarding insurance claims, denials, and reimbursements • Assigned appropriate billing codes to claims as needed • Observed all Medicare, Medicaid, and other applicable medical law

Claims Management Duties & Responsibilities Utilize efficient workflow organization to improve departmental efficiencies while ensuring effective client response and diligent analysis of claims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioClaims Management Duties & Responsibilities Utilize efficient workflow organization to improve departmental efficiencies while ensuring effective client response and diligent analysis of claims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professionalism