3 jobs found in Raleigh

Description: Join the Karna Team as a Temporary, Full-Time Medical Claims Processor. Become an integral part of a team dedicated to servicing the World Trade Center Health Program. In this role, you will leverage your meticulous attention to detail and commitment to accuracy in processing complex medical claims. If you’re eager to make a positive impact in our community through your administrative skills, we encourage you to apply! *Minimum of 5 years’ experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Job Responsibilities: Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. Critical Analysis: Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios. Timely Processing: Ensure claims are processed...

Overview: The Patient Finance Representative will help patients seamlessly navigate complex billing, financial and insurance workflows. The Patient Finance Representative will accurately perform administrative duties required to work queues, provide estimates, confirm insurance, secure authorizations, answer billing questions, provide estimates and collect payment. As a liaison to patients, the community, and healthcare professionals, this position requires excellent interpersonal and communication skills to ensure delivery of the highest quality customer service. The Patient Finance Representative work environment is a professional setting where in-bound and outbound calls to patients, insurance companies and other professional organizations are made. The Patient Financial Representative is a metrics-driven, task-based, self-regulated career focused on assisting patients and families by collecting payments, helping them understand the cost of care and providing financial...

Overview: Oversees the data gathering, financial modeling and creation of ad hoc financial reports using multiple database systems for the Managed Care department. The financial models and reports are used for contract negotiations, auditing purposes, and validating claim payments to help assist senior level leadership in the decision-making process. The role is also responsible for maintaining and auditing the current financial models in the finance database system for accurate reporting, and investigating over and under payments for claims variances and participating in various department related special projects Department Description: Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit  www.wakemed.org . EOE Licensure: Not Applicable...