- Mass Markets (Killeen, TX)
- …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
- AdventHealth (Apopka, FL)
- …for all activities regarding Rx Plus Pharmacy's state licensed data entry, claims adjudication , prior authorization, pharmacy specialist , and technician ... of prescription order intake of various media, technician quality assurance, claims adjudication and copay assistance, prior authorization, and prescription… more
- AON (NY)
- …is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your ... and written communication. Skills that lead to success: + Claims adjudication experience. + Clear and professional... Specialist II Do you have experience in claims adjudication and enjoy resolving issues for… more
- UPMC (Pittsburgh, PA)
- UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected ... Virginia workers comp adjuster license. The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims … more
- Sedgwick (Fort Worth, TX)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Licensed Auto Claims Adjuster - Bodily Injury Specialist (New York License Required) ... claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Research Specialist will oversee and manage research efforts related to claims overpayments, underpayments, ... and working collaboratively with providers and internal departments to enhance claims processes and improve financial outcomes. **Essential Functions:** - To… more
- University of Washington (Seattle, WA)
- …Medicine Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is ... responsible for claims review, clearing claim edits, and timely and accurate...rejections, or forwarding the claim to a medical coding specialist for review and coding changes prior to submitting… more
- Trinity Health (Columbus, OH)
- …**Description:** Successful candidates will have a strong understanding of Medical claims particularly within Medicare guidelines. Researching claims that do ... audit, provider relations and more. **Position Purpose** Contracts/Benefits Configuration Specialist position performs a variety of analytical and configuration… more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... 011250 CCA- Claims Hiring for One Year Term **_This position...the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
- CDPHP (Latham, NY)
- …Representative shall assume full responsibility and ownership for all aspects regarding claims adjudication and adjustments. In addition, the incumbent will ... diploma or GED required. + Minimum of one (1) year experience in health care claims review and adjudication to payment/denial utilizing CPT-4, ICD 10 and HCPCS… more
- Allied Solutions (Plano, TX)
- …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
- Dignity Health (Bakersfield, CA)
- …advanced-level role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims . This position requires expert ... knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and… more
- UNUM (Chattanooga, TN)
- …level technical position responsible for the thorough, fair, objective, and timely adjudication of the most complex short-term disability claims in conjunction ... providers. **Principal Duties and Responsibilities:** + Timely and accurate adjudication of complex STD claims + Processing...or more years in the Leave or Disability Benefit Specialist role + Mastery of all key responsibilities and… more
- AIG (Atlanta, GA)
- …service with empathy and efficiency. How you will create an impact The Specialist will handle and analyze general liability claims under general supervision ... claims involving litigation. The position also ensures ongoing adjudication of claims within the Company standards, industry best practices and specific… more
- Sedgwick (Augusta, ME)
- …difficult unemployment claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices or ... as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Unemployment Specialist **PRIMARY PURPOSE** : To analyze complex or technically… more
- TEKsystems (West Des Moines, IA)
- …identified claims issues, repetitive errors, and payer trends to expedite claims adjudication Work accounts in assigned queues in accordance with ... would be huge for this role! Will be bulk claims and denial work - no patient calling. -...Medicaid experience preferred. The Insurance Billing and Follow Up Specialist II will be responsible for performing all billing… more
- Army National Guard Units (East Greenwich, RI)
- …EXCEPTED SERVICE POSITION. This National Guard position is for a PERSONNEL SECURITY SPECIALIST (T32), PD# NGD2481000 and is part of the RI Joint Force Headquarters. ... primary purpose of this position is to serve as a Personnel Security Specialist , responsible for processing personnel security clearances and all tasks related to… more
- UPMC (Bridgeville, PA)
- …via telephone, e-mail and face to face required. + Knowledge of electronic claims adjudication and resolution required + Experience with prioritizing and ... is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides...dedicated team! This position provides prescription data entry and adjudication of claims under the supervision of… more
- Community Health Systems (Birmingham, AL)
- As a Billing Specialist at Grandview Medical Group you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our ... and student loan assistance for eligible roles. **Job Summary** The Billing Specialist II is responsible for managing complex billing functions, ensuring timely and… more
- Percepta (Melbourne, FL)
- …bring first-class service across each market we support. As a **Technical Support Specialist ** working **in Melbourne, Florida,** you'll be a part of creating and ... being part of a unique culture. **What You'll Be Doing** The Technical Support Specialist 's role is to consistently improve and maintain a high level of professional… more