- 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:** +… more
- Commonwealth of Pennsylvania (PA)
- …clerical work experience that includes collecting, recording, compiling, or preparing documents for medical , health , or work-related insurance claims ;or + An ... experience that includes collecting, recording, compiling, or preparing documents for medical , health , or work-related insurance claims do you possess? +… more
- Mount Sinai Health System (New York, NY)
- …Cycle Manager. **Qualifications** + Associates Degree preferred + 5 years experience in medical billing or health claims , with experience in IDX ... Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and...Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- …CPC Preferred + Training in computerized medical billing + 3 years experience in medical billing or health claims , with experience in IDX billing systems ... these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution....Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- …diploma/GED plus 3 years of relevant experience + Certified coder required + Experience in medical billing or health claims , with experience in EPIC & IDX ... these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution....Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- …high school diploma/GED plus 2 years of relevant experience + 2 years experience in medical billing or health claims , with experience in IDX billing systems ... accounts via online work file and/or hard-copy reports; checks claims status, re-submits claims , and writes appeal...Health System is one of the largest academic medical systems in the New York metro area, with… more
- CVS Health (Bloomington, MN)
- …data, clinical protocols, and medical notification documents within CVS Health 's Medical Claims and Prior Authorization platform (Novologix). ... At CVS Health , we're building a world of health...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CVS Health (Bloomington, MN)
- …data, clinical protocols, and medical notification documents within CVS Health 's Medical Claims and Prior Authorization platform (Novologix). ... At CVS Health , we're building a world of health...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Humana (Annapolis, MD)
- …benefits + Prior experience in a medical office setting + Experience with medical claims / health insurance + Experience in Provider relations + Bachelor's ... billing, claims , referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics.… more
- MVP Health Care (Tarrytown, NY)
- …working in the medical community ( medical office, medical records, medical billing), claims processing, health care or health insurance ... At MVP Health Care, we're on a mission to create...responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information,… more
- International Medical Group (Indianapolis, IN)
- …hospital, and other insurance companies; initiating or conducting investigation of questionable claims . + Documents medical claims actions by completing ... values. QUALIFICATIONS + At least 1 year of prior medical claims processing experience OR willing to...SKILLS + Knowledge of ICD-10 + Knowledge of FDA Health and HIPAA Regulations PERKS + Quarterly performance bonus… more
- Humana (St. Paul, MN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... focus on collaborative business relationships, value based care, population health , or disease or care management. Medical ...population health , or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal… more
- Humana (Raleigh, NC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … more
- LA Care Health Plan (Los Angeles, CA)
- …corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. This includes medical , vision, dental, behavioral ... Specialty Health Plans Auditor III Claims Job...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …development and promotional opportunities. All Levels + LPN, Medical Assistant, Health Plan customer service or claims processor experience with a minimum ... benefits, consistent with products, policies and procedures and related health plan functions such as member services, claims...medical care setting required. + Working knowledge of medical terminology and the claims systems required.… more
- Humana (Topeka, KS)
- …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health … more
- Providence (CA)
- **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many states eligible.** **Providence caregivers are ... we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,… more
- Humana (Honolulu, HI)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health … more
- Kelly Services (Glastonbury, CT)
- **Job Title:** ** Medical Claims Account Manager** **Reports To:** CFO **FLSA Status:** Exempt **Job Type:** Permanent / Full-Time **Schedule:** Monday - Friday, ... 9:30 AM - 6:00 PM **Location:** Glastonbury, CT 06033 **Summary** The Medical Claims Account Manager is responsible for delivering high-quality client service… 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