- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Senior Pharmacy Claims Professional adjudicates pharmacy claims and process ... pharmacy claims for payment. The Senior Pharmacy Claims Professional work assignments involve moderately complex to complex issues where the analysis of… more
- HomeSafe Alliance (Arlington, VA)
- **Title:** Claims Adjuster (SCA) HHG/Military Move **_HomeSafe Alliance_** is the single global household goods movement manager of over 300,000 Military Household ... are currently seeking a highly skilled and motivated Assistant Claims Manager to assist in all aspects of ...customer disputes and inquiries, assuring timely response per company policy whether the dispute is in writing or by… more
- Sedgwick (Washington, DC)
- …not limited to: claimant, client, state agency, managed care organization and appropriate medical contact. + Ensures claims files are properly documented and ... regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than… more
- System One (Fairfax, VA)
- …to send pending claims to ensure accurate completion according to medical policy , contracts, policies, and procedures allowing timely considerations to be ... staffing a contract to hire opportunity for a Healthcare Claims Processor to support a leading health ...100% Remote Contract to hire ESSENTIAL FUNCTIONS + Performs claims adjudication for complex medical claims… more
- Lincoln Financial Group (Washington, DC)
- …a Glance** We are excited to bring on a highly motivated Long-Term Disability (LTD) Claims Specialist to our claims organization. **What you'll be doing** As an ... LTD Claims Specialist, you will manage a workload of Long-Term...initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations.… more
- Sedgwick (Alexandria, VA)
- …regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Commercial Auto Claims Representative - Liability **PRIMARY PURPOSE** : To analyze and process… more
- Lincoln Financial Group (Washington, DC)
- …Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist** to support our ever-growing claims organization in a work from home ... west coast employer groups. _Background details_ As a Group Claims Specialist, you will support our Short Term Disability...requests relating to Short Term Disability, the Family and Medical Leave Act (FMLA), the Americans with Disabilities Act… more
- Sedgwick (Alexandria, VA)
- …regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Manager | VA Jurisdiction | Remote **PRIMARY PURPOSE** : To manage… more
- General Dynamics Information Technology (Fairfax, VA)
- …**Job Family:** Functional Experts **Skills:** Analytical Thinking,Data Analysis,Medicare Claims ,Medicare Policy ,Medicare Regulations **Experience:** 8 + years ... requests. + Receives and replies to requests for clinical, policy and medical coding support for Medicare,...package for all US-based employees includes a variety of medical plan options, some with Health Savings… more
- Georgetown Univerisity (Washington, DC)
- …Scientist will be to support research at the McCourt School of Public Policy (http://mccourt.georgetown.edu/) and the School of Health related to Medicaid. MDI ... position will be part of the technical team of Health Service researches and Data Analysts. The Team is...our technical and analytical capability supporting research with large claims datasets. Duties include, but are not strictly limited… more
- Highmark Health (Washington, DC)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... work. + Calculate rates, employ different financial arrangements, interpret pricing policy and adapt to unusual situations. + Identify questionable claim patterns… more
- Elevance Health (Washington, DC)
- …working knowledge of CPT/HCPCS and ICD 10 coding and medical policy guidelines strongly preferred. + Prior health care fraud audit/investigation experience ... potential fraud and over-utilization by performing the most complex medical reviews via prepayment claims review and...areas of identified problems or providers, recommending modifications to medical policy , and policy edits.… more
- Travelers Insurance Company (Chantilly, VA)
- … with lost time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a ... Medical Case Manager. Independently handles assigned claims ...+ Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical … more
- Trinity Health (Aspen Hill, MD)
- …+ High school graduate possessing three (3) years experience in accounting and medical claims management, preferably in a hospital or physician's office setting. ... thru Friday) **Position Highlights:** + **Competitive salary** + **Benefits -** Medical , Dental & Vision, PTO, Free Parking, Metro Access, Tuition Reimbursement,… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of ... experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and… more
- Travelers Insurance Company (Chantilly, VA)
- …input and shares ideas. + Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. ... reserving, negotiating and resolving assigned Construction Defect and Property Damage claims . Provides quality claim handling throughout the claim life cycle… more
- Travelers Insurance Company (Chantilly, VA)
- …involvement of supervisor preferred. + Thorough understanding of business line products, policy language, exclusions, ISO forms, and effective claims handling ... reserving, negotiating and resolving assigned Construction Defect and Property Damage claims . Provides quality claim handling throughout the claim life cycle… more
- Elevance Health (Washington, DC)
- …equivalent background. + Health insurance experience required with understanding of health insurance policies, health insurance claims handling and ... ideal candidate will live within 50 miles from one of our posted Elevance Health locations._ Carelon Payment Integrity is a proud member of the Elevance Health… more
- Travelers Insurance Company (Chantilly, VA)
- …is responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and payment ... multiple state jurisdictions. Claim types include moderate complexity Bodily Injury claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Humana (Washington, DC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... well as a focus on collaborative business relationships, value based care, population health , or disease or care management. Medical Directors support Humana… more