Reviews, processes, and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. Provides prompt feedback to physicians and management regarding pathway documentat

The Underwriting Assistant provides support and assistance to all levels of Underwriters, Underwriting Managers and Division Managers. Essential duties include collecting and reviewing data for new and renewal business and performing administrative duties for underwriting as requested. Duties and Responsibilities Continuously exhibit and uphold Core Values of Integrity, A

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Directly report to and support the Program Manager by overseeing a team of claims processing automation analysts in the successful delivery of services across all assigned task areas including, but not limited to, automation review, claims processing, and quality assurance. Participate in scheduled calls with the customers, partners, and vendors. Continually assess operat

The Senior Claims Examiner will manage a caseload of insurance claims pending under a moderate to low level of supervision. Job functions include the following Analyzing insurance claims to determine applicable coverage; Analyzing claims to determine the extent of insured's or insurer's liability; Reviewing and evaluating damages and determining strategies for resolution.

Insurance Verification Specialist Medical Receptionist Leesburg, VA MUST Experienced Insurance Verification Specialist Medical Receptionist/ Front desk 2+ years of experience as an Insurance Verification / Pre Authorization Specialist Experience obtaining insurance verifications and pre authorizations Scanning medical records Ability to review benefits with patients Abili

Essential Duties & Job Functions Operates keyboard controlled data entry devices such as computer, key operated magnetic tape, or disc encoder to transcribe data into a format suitable for computer processing. Operates an alphanumeric keyboard and transcribes procedures and relevant data entry equipment. Works under close supervision and follows specific procedures or det

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the

Performs insurance verification for all scheduled patient services and obtains required precertifications in a multi disciplinary environment. Two of the four skill levels required 1. One year experience in healthcare environment or 2. Completion of healthcare related certificate program 3. One year experience with medical insurance in a hospital or physician office or 4.

This position is responsible for ensuring institutional compliance with the Virginia Department of Behavioral health and Developmental Services, Virginia Medicaid Services, Tricare and Joint Commission. This position is tasked with ongoing compliance audits of current medical records. Key Responsibilities The Medicaid Specialist is tasked with auditing all open charts con

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This is a hybrid role; 3 days in office, 2 days remote The Claims Examiner investigates, and processes Workers' Compensation claims for VCUHS employees. This job assists in the coordination of an effective commercial insurance and self insured Workers' Compensation Claim Program that is compliant with state laws and that meets the needs of VCUHS. This job is responsible f

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