- Inland Empire Health Plan (Vallejo, CA)
- …and to pivot from a "job" opportunity to an authentic experience!The Supervisor, Claims Processing - Medi-Cal provides daily oversight of claims staff, business ... processes and inventory management. Ensures the claims team follows state/federal regulations and standard operating procedures. Develops best practices to optimize… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …from a "job" opportunity to an authentic experience!Under the direction of the Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible ... for ensuring the compliance of IEHP's claims payment system and processes by auditing claim payments...Responsibilities)1. Audit internal systems and controls to ensure the claims system is set up correctly and claims… more
- Great West Casualty Company (Montgomery, AL)
- …out of the shop and into the field with a career as a Commercial Auto Claims Field Adjuster. This position is fully remote and will be located in or around the ... Montgomery, AL area.As a Commercial Auto Claims Field Adjuster for Great West, you will investigate,...for Great West, you will investigate, negotiate, and settle claims in the field by estimating equipment and cargo… more
- Great West Casualty Company (Arlington, TX)
- We are hiring a Liability Claims Adjuster to work in a hybrid capacity at our Arlington, TX location.Are you a confident decision-maker looking to take the next ... career? Do you have extensive experience working with commercial or auto liability claims ? Join Great West Casualty Company, a stable industry leader, as a Liability… more
- PharMerica (Concord, NH)
- …milligrams)May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS)Maintains current knowledge of Medicaid claim ... regulations and processesMay produce reports and keep management informed of unpaid claims and claims pending follow-upProvides excellent customer service to… more
- King's Seafood Company (Costa Mesa, CA)
- …protection and prevention.Manages audits and tracks all worker's compensation claims including all required forms and timelinesParticipates in quarterly reviews ... with TPA to ensure claims are being handled properly; takes appropriate action if neededResearches and analyzes data pertaining to any trends or patterns of… more
- Presbyterian Healthcare Services (Albuquerque, NM)
- …data from back-end transactional systems. Healthcare domain experience in Enrollment, Claims are preferred. This role will be accountable for break/fix operational ... development, and production support.Health plan knowledge with emphasis on claims operations, financial reconciliation, provider networks, claims management… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …initiatives. Supports on-going analyses of financial, budgetary, or medical claims data, through forecasting, statistical analyses, trending, regression analyses, ... Responsibilities)1. Supports on-going analyses of financial, budgetary or medical claims data, through forecasting, statistical analyses, trending, regression analyses,… more
- Washington DC Pediatric Dental Office (Washington, DC)
- …between our practice and insurance providers, ensuring seamless processing of claims and maximizing coverage for our patients. Your responsibilities will include:* ... patients* Collaborate with offsite biller with submitting and tracking insurance claims * Providing assistance and guidance to patients regarding insurance coverage… more
- PharMerica (Horsham, PA)
- …as neededIdentifies and resolves issues of denials or follow-up of claims , by maintaining current knowledge of Medicaid claim regulations and processesParticipates ... in operating a computerSkilled in performing detailed workKnowledge of Medicaid claims regulations and processesAs required by state, technician licensure or… more
- Intermountain Healthcare (St. George, UT)
- …illness or injury. This includes: Acts as a liaison for Workers Compensation claims including working with claims adjustors and providers, Develops and maintains ... a relationship with WorkMed clinics or applicable occupational health providers, Facilitates work restrictions and accommodations, Provides worksite evaluations and ergonomic assessments as needed, Facilitates return to work for employees on health related… more
- Humana (OK)
- …CPC, CCS, CFE, AHFI)* Analytical background* Understanding of healthcare industry, claims processing and investigative process development* Experience in a corporate ... experience? Yes or No* Do you have an understanding of healthcare industry, claims processing and investigative process development? Yes or No* Have you ever worked… more
- Wraith Scarlett & Randolph (Vallejo, CA)
- …send correspondence on all new and renewal policies to the clientReport all new claims and manage ongoing claims as neededProcess policy cancellations and notify ... clientThoroughly document accounts using the agency's management systemMaintain working knowledge of crop insurance regulatory rules along with carrier regulations and policiesSkills and Specifications:Advanced knowledge of insurance companies and Crop… more
- Elite Construction Solutions (Denver, CO)
- …managed repair program, actively participating in the sales efforts of assigned claims . You will be responsible for conducting on-site inspections, staying in touch ... with homeowners throughout the claims process, and obtaining signed contracts. Your attention to detail and excellent customer service skills will ensure that we… more
- United Wholesale Mortgage (Akron, OH)
- …advice on title related issues* Reviewing and assisting with title claims * Researching deed, filing, and other title related legal requirements* Communicating ... with title companies regarding processing and procedural issues* Ensuring compliance with UWM policies and procedures* Editing legal documents for accuracy* Providing support and assistance to members of the Legal teamWHAT WE NEED FROM YOU:Must Have… more
- PRISM Vision Group (New Providence, NJ)
- …issuesCustomer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family membersAble ... to work in a team environmentProblem-solving skills to research and resolve discrepancies, denials, appealsKnowledge of medical terminologyKnowledge of CPT/ICD-10 and modifier coding more
- Presbyterian Healthcare Services (Albuquerque, NM)
- …data is a plus.Exposure or experience with Health Rules Payor (HRP) Claims Information is a plus.Coding experience with JavaScript is essential.Experience with ... React.js and Node.js.Experience with HTML and CSS.Experience with integration platforms, preferably Boomi.Experience developing and maintaining API's with Java is a plus.Coding experience with Oracle PL/SQL is a plus.Qualifications:Bachelor s degree in related… more
- Rocky's Ace Hardware (Springfield, MA)
- …service, by greeting and assisting customers on the sales floor* Resolve customer claims and complaints in a manner that is timely, courteous and discreet* Authorize ... refunds in a manner that is consistent with company policy* Work with the processing of weekly hot sheets and price adjustments ensuring store bin tagging completed in a timely manner* Attend and assist with mandatory monthly store meetingsOther… more
- United Wholesale Mortgage (NM)
- …advice on title related issues* Reviewing and assisting with title claims * Researching deed, filing, and other title related legal requirements* Communicating ... with title companies regarding processing and procedural issues* Ensuring compliance with UWM policies and procedures* Editing legal documents for accuracy* Providing support and assistance to members of the Legal team*WHAT WE NEED FROM YOU:** Admission to the… more
- Wilson Medical Center (Wilson, NC)
- …and timely documentation updated in the EHR. 8. Submits electronic WC claims within the established timeframe. 9. Investigates accidents and injuries and works ... with leadership to determine action plans for further mitigation. 10. Provides general nursing care to employees (ie BP/BS checks/allergy injections, etc.) 11. Collaborates with the EH Medical Director and follows standing orders as approved by the Medical… more
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