- Cognizant (Lansing, MI)
- ** Claims Quality Review ** ( remote ) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** Our ... quality standards, processes and procedures and policies + Ensures the claims processing reps adhere to predetermined quality assurance standards and the… more
- Providence (CA)
- **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many states eligible.** **Providence caregivers are not ... empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, general,… more
- Sedgwick (Troy, MI)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... Des Moines, IA or Troy, MI - Hybrid or Remote MI Are you looking for an opportunity to...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- NTT DATA North America (Ontario, CA)
- …**NTT DATA Services currently seeks a Senior Claims Examiner to join our team working 100% Remote and work on the PST hours of 8 am - 5 pm. This is a temporary ... audits, and process optimizations. **Key Duties & Responsibilities** -Adjudication & Review -Process comprehensive medical claims using Xcelys and associated… more
- NTT DATA North America (Plano, TX)
- …DATA and for the people who work here. NTT DATA is seeking to hire a ** Remote Claims Processing Associate** to work for our end client and their team. **NOTE** ... the right people on board, anything is possible. The quality , integrity, and commitment of our employees are key...training of NTT Data/Client + Work independently to research, review and act on the claims +… more
- Sedgwick (Tampa, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Workers Compensation ( Remote - Southeast State exp needed) ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- NTT DATA North America (Plano, TX)
- …executed as part of an overall sourcing strategy. NTT DATA is seeking to hire a ** Remote Claims Processing Associate** to work for our end client and their team. ... the right people on board, anything is possible. The quality , integrity, and commitment of our employees have been...training of NTT Data/Client + Work independently to research, review and act on the claims +… more
- NTT DATA North America (Plano, TX)
- NTT DATA is currently seeking 20 Remote Claims Examiners to join our team. (Amisys or Xcelys experience is a plus) Must be able to work Monday to Friday 7 AM to ... training of NTT Data/Client + Work independently to research, review and act on the claims +...defined workflows, guidelines + Sustaining and meeting the client productivity/ quality targets to avoid penalties + Maintaining and sustaining… more
- TEKsystems (Harrisburg, PA)
- TekSystems is currently hiring for a FULLY REMOTE Claims examiner contract position! THIS POSITION CAN START ASAP! MUST HAVE: 1-3 years of recent medical ... complex or high-risk cases for further investigation or legal review . Skills customer service, healthcare industry, claims ...on business needs. - Must be able to meet quality , productivity, and behavior expectations. - Must possess basic… more
- NTT DATA North America (Plano, TX)
- …the timelines to complete compliance training of NTT Data/Client -Work independently to research, review and act on the claims -Prioritize work and adjudicate ... the right people on board, anything is possible. The quality , integrity, and commitment of our employees have been...overall sourcing strategy. NTT DATA currently seeks a **Medical Claims Processor** to join our team in **Plano, TX… more
- Cognizant (Santa Fe, NM)
- …and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review / quality assurance procedures + Must be able ... to transform a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims … more
- Zurich NA (Springfield, IL)
- … Specialist, your primary accountabilities will include: + Work the most complex claims , involving multiple causes of loss, multiple quality issues, subrogation ... policies with the ability to change unit structure pending review outcome + Completes claims on specialty...area + Completes Crop Hail re-inspections when requested for quality assurance purposes + Works claims of… more
- The Hartford (San Antonio, TX)
- Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... help shape the future. This is a visible and important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims… more
- Zurich NA (Des Moines, IA)
- …Adjuster II, your primary accountabilities will include: + Work the most complex claims , involving multiple causes of loss, multiple quality issues, subrogation ... policies with the ability to change unit structure pending review outcome + Completes claims on specialty...area + Completes Crop Hail re-inspections when requested for quality assurance purposes + Works claims of… more
- Brighton Health Plan Solutions, LLC (NC)
- …on claims requiring adjudication. + Review and process High Dollar claims and conduct quality reviews of claims and logic changes/updates. + ... reports. The expectations include providing coaching, mentoring, and training while promoting quality and superior customer service. The Claims Supervisor is… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the ... Assurance, this role is responsible for the end-to-end review , analysis, and resolution of complex reimbursement issues -… more
- Zurich NA (Maitland, FL)
- …escalating issues as appropriate. + Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and ... WC Senior Claims Specialist 126746 At Zurich North America ...available tools and resources within authority limits. + Meet quality standards by following best practices Basic Qualifications: +… more
- NTT DATA North America (Ontario, CA)
- …to system enhancements, audits, and process optimizations. **Responsibilities** Adjudication & Review + Process comprehensive medical claims using Xcelys and ... NTT DATA is currently seeking **Senior Medical Claims Examiners (3+ years of Xcelys required)** to...join our US based team. This is a 100% remote role. **Must be able to work 8:00 am-5:00… more
- ManpowerGroup (Sacramento, CA)
- …assure that payments are appropriate. The Claims Manager will collaborate with claims review service provider(s) staff and ensure all claim reviews are ... years experience which will align successfully in the organization. **Job Title: Claims Director** **Location: Remote , preferred in Sacramento, CA** **Pay Range:… more
- NTT DATA North America (MO)
- …the timelines to complete compliance training of NTT Data/Client * Work independently to research, review and act on the claims * Prioritize work and adjudicate ... **Job Title** : Medial Claims Processor **Industry** : Healthcare **FSLA status** :...defined workflows, guidelines * Sustaining and meeting the client productivity/ quality targets to avoid penalties * Maintaining and sustaining… more