Sentences with phrase «performing claims review»

Not exact matches

McGlynn has supervised and performed 13 - week cash flow, business plan, recovery, and claims analyses as well as asset reviews.

«Board members were not aware that they should perform a deliberate and thorough review of claims.

Testimonials and reviews on our website, social media and third - party review sites are not intended, nor should they be construed, as claims that our vehicles or services perform or do more than what is intended by the vehicle and our services.

By posting or uploading any Content on the Website: (i) you understand that if your Work is in aliterary categoryincluded on the Book Country Website, and complies with these General Terms of Use, your Work may be made accessible to users of the Website and members will be able to review, comment on it and rate it; (ii) you represent and warrant that (A) the Content does not contain any libelous matter or matter otherwise contrary to law or violate any rights of privacy or other personal or property right whatsoever and (B) you own or control all rights in your Content, that such Content is original and does not, and will not, infringe the copyright, trademark or any other right of any person or entity, and that any «moral rights» in the Content have been waived; and (iii) you grant to us a non-exclusive, worldwide, royalty - free, irrevocable, perpetual, transferable right and license (A) to display the Content on the Website, and (B) with respect to Content other than your Work, to use, display, reproduce, distribute, modify, adapt, publish, translate, create derivative works from, perform, make, sell and export such Content, in whole and in part, on the Website or in any formats and through any media, as we see fit, and you shall have no claims against Book Country for such use or non-use.

The Court of Appeal's decision ensures that litigation funders are incentivised to: (i) conduct thorough due diligence before funding a claim; and (ii) remain involved by performing periodic reviews of the litigation strategy.

Because employees of the plan sponsor often perform health care operations and payment (e.g. plan administration) functions, such as claims payment, quality review, and auditing, they may have legitimate need for such information.

It's always beneficial to use an authorized Chevrolet collision center to perform your repairs, as local auto repair shops might not review your vehicle appropriately, and this will prevent you from obtaining maximum claim benefits from your insurance company.

By submitting an entry, you: (a) irrevocably grant the Sponsor, its agents, licensees, and assigns the unconditional and perpetual (non-exclusive) right and permission to copyright, reproduce, encode, store, copy, transmit, publish, post, broadcast, display, publicly perform, adapt, modify, create derivative works of, exhibit, and otherwise use your entry as - is or as - edited (with or without using your name) in any media throughout the world for any purpose, without limitation, and without additional review, compensation, or approval from you or any other party; (b) forever waive any rights of copyrights, trademark rights, privacy rights, and any other legal or moral rights that may preclude the Sponsor's use of your entry, or require any further permission for the Sponsor to use the entry; and (c) agree not to instigate, support, maintain, or authorize any action, claim, or lawsuit against the Sponsor on the grounds that any use of the entry, or any derivative works, infringes any of your rights as creator of the entry, including, without limitation, copyrights, trademark rights, and moral rights.

Fitch's financial sector ratings are performed by a staff of trained analysts who review each company on several factors including the ability to meet commitments such as interest and dividend payments, the company's ability to withstand a major surge in claims, and how well the company has performed economically.

At this moment in time, it is hard to say if Halong machines perform as well as the company's claimed specifications but it is likely reviews of these machines will come shortly.

Perform Clinical Claim Review and Processing assessment that configures diagnosis (ICD - 9) and CPT and HCPCS procedure codes for limitations and medical necessity, consistently suppressing more than $ 1M each quarter.

Perform First Level Claims Reviews, ensuring there is documentation to support the medical necessity of the claim to Medicare Part B.

Perform other duties as assigned, such as recalculating a difficult claim, reviewing and responding to claim audits from Management or the Client.

Coding Specialist • Handle development of new coding policies and procedures • Ensure accuracy of coded services and make sure that they are complete • Manage accurate and timely ICD - 9 and CPT code selection in accordance to services performed • Handle reviewing duties aimed at claims accuracy and coding compliance • Ensure that patient statements are properly reviewed • Assist in processing payments from insurance companies • Handle organization of patient charts and follow upon claims • Investigate reasons for rejected claims and handle paperwork for refilling claims • Assist in investigating insurance frauds and take appropriate measures to report them

Review letters and outgoing correspondence, perform a second level review of claims, assist teams and review leReview letters and outgoing correspondence, perform a second level review of claims, assist teams and review lereview of claims, assist teams and review lereview letters.

conducted research on deceased borrowers and heirs using Westlaw and local county online services prepared contact letter to heirs drafted correspondence and pleadings for creditor's administration and requests to the underwriter to insure around deceased borrower coordinated with attorneys, dependent administrators and local counsels with hearings updated to clients with status of loans handled by the firm performed title reviews and determine if title claims are needed for prior liens, missing conveyances, legal discrepancies referral administrator.

Delta Care, Front Royal, VA 3/2013 — Present Medical Administrative Assistant • Greet patients and their families as they arrive at the facility and inquire into their appointment status • Check scheduled appointments and perform patient intake and registration duties • Schedule new appointments over the telephone, in person and through email and follow - up with existing patients • Review and validate health cards and insurance information, obtaining coverage information • Create priority list for patients based on appointment statuses and emergency situations • Gather information for patient charts and ensure that all patients» records are kept current • Contact insurance companies to acquire information of patient coverage and to process claims • Coordinate efforts with procurement officers to ensure timely and accurate delivery of medical supplies and equipment

Performed all administration services to health plans, services including pre-certification, utilization review, and claims notification.

PROFESSIONAL EXPERIENCE Hallmark Service Corporation, Naperville, IL 2005 — 2011 Claims Investigator / Examiner (Membership Review / Risk Management Unit) Performed detailed reviews and investigations for claims filed on individual health insurance policies for the states of TX, IL, NM aClaims Investigator / Examiner (Membership Review / Risk Management Unit) Performed detailed reviews and investigations for claims filed on individual health insurance policies for the states of TX, IL, NM aclaims filed on individual health insurance policies for the states of TX, IL, NM and OK.

QUALIFICATIONS Over 6 years» experience in performing and dealing with all sorts of claims and related tasks such as gathering required information including: police reports, photos, recorded statements and even criminal records to ensure the authenticity of the case by thoroughly reviewing details, investigating and examining.

• Hands - on experience in performing checks on accounts for claims for billing review.

Looking for a Medical Billing Specialist to perform the following: - Review of electronic claims.

• Greeted patients as they enter the facility • Took patient information for record purposes • Maintained demographic and insurance information • Verified information by interviewing patients • Reviewed medical history and took vital signs • Educated patients about the facility's policies and medical procedures • Recorded billing information • Managed supplies and equipment • Maintained a safe and clean environment for the patients and the doctors • Liaised with insurance companies • Created and maintained record systems to ensure that patients» information was properly recorded • Manned the telephone exchange, answered telephone calls and provided required information • Registered new patients by assisting them in filling out registration forms and providing them with information on required documents • Prepared examination rooms by ensuring that all equipment and supplied were available and in good working order • Assisted doctors in performing examinations by operating medical equipment and providing them with supplies needed to complete the procedure • Prepared patients for examinations by assisting them in changing into robes and providing them with information on what to expect during the procedure or examination • Created and maintained effective liaison with insurance companies to verify patients» insurance coverage information • Contacted insurance companies to determine the status of submitted claims and follow up on delayed or unpaid claims • Calculated co-pays and provided patients with information on how much coverage their insurance company will provide to them for each procedure • Created and implemented supplies inventory systems and contacted vendors and suppliers to ensure timely delivery of equipment and supplies • Provided one on one information of what to expect from a procedure to patients and their families • Administered medication to patients and ensured that medicine refill requests are timely filled • Oversaw the cleanliness, maintenance and sterilization of medical equipment after each procedure • Scheduled patients for appointments and performed follow up duties to ensure that all appointment slots are filled • Handled any cancelled appointment slots by allotting them to patients on the facility waiting lists

• Organized and processed paperwork, reports and all kinds of claims documentation • Entered, recorded and reviewed claims into claims information management system • Performed verification checks on the customer / claimant loss - claims following company's standard policies and procedures • Attended to clients, claimants, field appraisers and management queries, regarding claims using the claims MIS • Forwarded appropriate claims for new losses verifying data for accuracy • Performed billing and payment processes • Processed routine claims transactions related to reserves and issued required checks or receipts • Resolved all kinds of issues / problems regarding claims and payments • Regularly run and generated claims reports for management • Gave formal presentations regarding all claims activities to the senior management at the bimonthly • Utilizing outstanding communication and interpersonal skills maintained strong and positive relationships with the providers, the claimants, and the clients • Provided company with necessary clerical support like handling fax, attending and making telephone calls as directed, filing and photocopying, matching checks with receipts etc. • Prepared, updated and organized customer and client's files • Managed all types of correspondence preparing, reviewing and sending memos, letters, emails, reports, applications, and forms • Provided effective CSR to providers, field appraisers, agents, insurance agencies, clients and customers • Matched incoming emails, mails, and faxes with the claims records • Arranged and set up medical appointments for health claims • Kept department's office supplies stocked • Maintained confidential claims information including correspondence with sensitive information • Accelerated claims correspondences as well as updated claims diaries • Worked in a team on several pilot claim projects • Reviewed and kept the record of closreviewed claims into claims information management system • Performed verification checks on the customer / claimant loss - claims following company's standard policies and procedures • Attended to clients, claimants, field appraisers and management queries, regarding claims using the claims MIS • Forwarded appropriate claims for new losses verifying data for accuracy • Performed billing and payment processes • Processed routine claims transactions related to reserves and issued required checks or receipts • Resolved all kinds of issues / problems regarding claims and payments • Regularly run and generated claims reports for management • Gave formal presentations regarding all claims activities to the senior management at the bimonthly • Utilizing outstanding communication and interpersonal skills maintained strong and positive relationships with the providers, the claimants, and the clients • Provided company with necessary clerical support like handling fax, attending and making telephone calls as directed, filing and photocopying, matching checks with receipts etc. • Prepared, updated and organized customer and client's files • Managed all types of correspondence preparing, reviewing and sending memos, letters, emails, reports, applications, and forms • Provided effective CSR to providers, field appraisers, agents, insurance agencies, clients and customers • Matched incoming emails, mails, and faxes with the claims records • Arranged and set up medical appointments for health claims • Kept department's office supplies stocked • Maintained confidential claims information including correspondence with sensitive information • Accelerated claims correspondences as well as updated claims diaries • Worked in a team on several pilot claim projects • Reviewed and kept the record of closReviewed and kept the record of closed files

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

Talented in determining the eligibility of medical claims by performing in - depth reviews of claim requests, adjudicating medical claims and taking appropriate actions to resolve discrepancies, utilizing up to date processes and procedures to update claims in the database and responding to claimants by staying within company standards to ensure absolute conformity and reduced risk for ambiguity.

Will answer inquiries, review data, monitor and ensure compliance, perform inspections, resolve claims.

VETERANS SERVICE REPRESENTATIVE * Performs initial reviews of claims and identifies types of evidence, Processes...

COVER LETTER: Respectfully Yours, Donna N. Roye - Morton Responsible for accurately performing a retrospective, concurrent and special claims reviews / audits on asbestos claims presented for payment before the various DCPF trusts.

Director of Human Resources / HR Consultant — Professional Duties & Responsibilities Oversee the planning, direction, and management of all HR - related activities including staff recruiting, candidate tracking, personnel screening and testing, and hiring processes in accordance with Affirmative Action and Equal Opportunity Employment regulations Support senior management to develop and maintain personnel policy and ensure compliance with all standards, authoring and implementing new policies and procedures as needed along with creating HR procedure manual Serve as lead analyst for compensation reviews, performance and pay - scale benchmarking, market studies, and salary structure decisions, also creating organizational / staff planning charts for all departments and all positions Create and deliver firm - wide staff new - hire orientation, training and development programs, and performance evaluations utilizing a competency - based appraisal system which leads to focused training and development programs based on common and individual areas of performance deficiency Manage all aspects of workers compensation and unemployment claims on behalf of employer, attending hearings and participating actively in all related meetings Hold responsibility for all benefit negotiations, administration, and plan reviews, promoting compliance with and effective execution of IRS / DOL regulations, ERISA, HIPPA, and all audit - related processes Implement and sustain safety programs while performing regular safety - policy trend analyses to identify critical issues, developing corrective action plans to ensure compliance with applicable safety, health, and environmental regulations including OSHA and other applicable laws Consult with management regarding employee - and labor - related issues to resolve conflicts in a professional manner, conducting grievance hearings and negotiation agreements with worker representatives within the provisions of any applicable contract Provide relevant guidance and administration to the development of human resources site on firm intranet, housing online - employment forms, manager resources, job postings, and HR - related forms and documents Develop valuable staff relationships to improve workplace morale as well as maintain positive business relationships with all related brokers and vendors