- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution, reporting… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the ... to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health... Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of … more
- AIG (Lenexa, KS)
- …skills and experience as a valued member of the team. Make your mark in Accident and Health Claims Our Claims teams are the proven problem solvers of choice ... at least 1+ year(s) with exposure to Identity Theft and/or Accident and Health claims , which include identity theft, sickness and bodily type injury claims … more
- Axis (Red Bank, NJ)
- …for candidates taking part in the selection process. Job Title: Accident and Health Claims Specialist Level: "I" Division: A&H Position Summary: This position ... provides claims handling expertise for all of the accident and health claims , both claims adjudicated in-house and by third party administrators (TPAs).… more
- Elevance Health (Woodbridge, NJ)
- …(word processing, spreadsheets, etc.) strongly preferred. + Previous experience working in health claims is strongly preferred. For candidates working in person ... ** Claims Representative I** **Location:** This role enables associates...Jersey, New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- CVS Health (Phoenix, AZ)
- … Analyst is responsible for reviewing pharmacy claims submitted through the CVS Health claims processing systems. The Claims Analyst will identify and ... At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming … more
- TEKsystems (Fresno, CA)
- …or equivalent: minimum one (1) to three (3) years year of experience as a Health Claims Examiner or comparable industry experience preferred. * A minimum of one ... for reviewing and processing medical, dental, vision and electronic claims in accordance with state, federal and health... claims in accordance with state, federal and health plan regulatory requirements, department guidelines, as well as… more
- WTW (Chicago, IL)
- …the posted locations. **Qualifications** **Qualifications** + 5+ years' experience in health claims adjudication gained preferably in a consulting environment ... and/or in a major insurance claims administrator or health plan environment + Solid understanding of health and welfare plan design and all areas of … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …or GED + Excellent oral and written communication skills + 1 - 3 years of Health claims processing experience + Working knowledge of COB and MSP preferably + ... Position Purpose: The Claims Examiner is responsible for providing expertise and/or...Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and adjusting… more
- Elevance Health (Roanoke, VA)
- **Title: Claims Representative I ( Health & Dental) - FEP** **Roanoke, VA** **Location:** This role enables associates to work virtually full-time, with the ... 10/20/2025** **Hours:** **8 AM - 4:30 PM EST, Monday - Friday.** The ** Claims Representative I** will be responsible for successfully completing the required basic… more
- Alight (TX)
- …and financially secure workforce by unifying the benefits ecosystem across health , wealth, wellbeing, absence management and navigation. With a comprehensive total ... role provides leadership and guidance to a team of Claims Specialist who work to resolve billing inquiries &...for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation… more
- UCLA Health (Los Angeles, CA)
- …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of all ... + Knowledge of claims adjudication systems + Flexibility and adaptability UCLA Health is a world-renowned health system with four award-winning hospitals and… more
- Ascension Health (Austin, TX)
- …**Additional Preferences** Additional Preference: + Three (3) years of experience in health -care claims adjudication required. + Expertise in the Facets platform ... Must reside in Austin, Texas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Claims Research and Resolution Professional 2 reports to the Claims Research and ... **Use your skills to make an impact** **Required Qualifications** + 2+years of health insurance claims experience, with claims systems, adjudication,… more
- Humana (Springfield, IL)
- …your skills to make an impact** **Required Qualifications** + 2+ years of health insurance claims experience, with claims systems, adjudication, submission ... part of our caring community and help us put health first** Humana Fully Integrated Dually Eligible (HMO D-SNP)...Dually Eligible (HMO D-SNP) in IL, is seeking a Claims Research & Resolution Professional claims educator,… more
- Kelly Services (Glastonbury, CT)
- …Ability to prioritize tasks and escalate concerns appropriately + Experience with health insurance claims , premiums, and regulatory compliance + Financial ... **Job Title:** **Medical Claims Account Manager** **Reports To:** CFO **FLSA Status:**...organizations. This role involves managing administrative processes related to health premiums and medical out-of-pocket expenses, handling client inquiries,… more
- CHS (Clearwater, FL)
- **Overview** ** Health Insurance Medical Claims Examiner** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims ... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and Responsibilities:** + Reviews and… more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... (ERM). Actual results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits** **Qualifications** **Qualifications… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Senior Claims Research and Resolution Professional reports to the Claims Research ... and is responsible for tracking and trending Michigan Medicaid claims data and completing root cause analyses of ...claims dispute resolution, and/or other related functions in health insurance. + Experience working in the health… more
- Access Dubuque (Dubuque, IA)
- …Captive Consultant Cottingham & Butler/ SISCO Dental Assistant Crescent Community Health Center Workers Compensation Claims Adjuster (Southeast Ex Cottingham ... Claims Assistant **Sedgwick** 1 Positions ID: R62460 Posted...disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ Sedgwick… more