- Guardian Life (Washington, DC)
- …Meet productivity requirements as established by department for handling Supplemental Health Claims . Leadership Behaviors + Demonstrates intellectual curiosity. ... have + Experience of 3 plus years processing Supplemental Health claims . (Accident, Critical Illness, Cancer and...flexible, and inclusive benefits and resources to our colleagues. ** Health Care** + Choice of [high deductible/copay] medical… 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 ... an SCA position** . **Position Summary** : **HomeSafe Alliance** is seeking experienced Claims Adjustors with experience in HHG/Military Move to process and settle … more
- Humana (Washington, DC)
- …**Preferred Qualifications** + Strong and proven experience with processing and adjudicating medical claims + Knowledge with CPT and ICD9 terminology/codes ... part of our caring community and help us put health first** The Claims Review Representative 3...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Lincoln Financial Group (Washington, DC)
- …professionals through phone and e-mail to gather information regarding Short Term Disability Claims , Family Medical Leaves, and state benefits when applicable. + ... a Glance** We are excited to bring on a highly motivated Integrated Absence Claims Specialist to staff our ever-growing claims organization. As an Integrated… 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 Claims Representative - Auto **PRIMARY PURPOSE** : To analyze...are properly documented and correctly coded based on the policy . + Develops and maintains action plans to ensure… more
- Lincoln Financial Group (Washington, DC)
- …Role at a Glance** We are excited to bring on a highly motivated Fast Track Claims Specialist to our ever-growing claims organization. As a Fast Track Claims ... contacting employers to secure necessary eligibility information, obtaining, and reviewing medical records and making timely and ethical claim determinations. You'll… 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
- Lincoln Financial Group (Washington, DC)
- …**The Role at a Glance** We are excited to bring on highly motivated Leaves Claims Specialists to staff our ever-growing claims organization. As a Leaves ... responsible for administering and managing leave requests relating to the Family and Medical Leave Act (FMLA), the Americans with Disabilities Act (ADA) as well as… 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 ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Auto Claims Manager **PRIMARY PURPOSE** : To manage the technical and operational… more
- Serco (Washington, DC)
- …unique combination of strong program management experience and subject matter expertise in medical records review and claims processing review for the Medicaid ... critical issues and program improvements to coordinate and optimize multiple aspects medical and claims review operations. **_Hybrid or full-time remote work.… more
- Amazon (Arlington, VA)
- …and tools that help them succeed, and enforce our policies when necessary. This Policy Manager will support the work we're doing to guide our buyers to perfect ... role will support the product and program teams working on Amazon's A-to-z Claims Guarantee, Seller Profile Page, Seller Reviews, and Order Performance. An ideal… more
- Serco (Washington, DC)
- **Position Description** Serco is seekingseveral motivated Eligibility Policy Analysts to join our talented and fast-paced Public Sector Solutions team in supporting ... Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as required by the… more
- Amazon (Arlington, VA)
- …and regulatory requirements; and (2) provide thought leadership and work with our policy lead to ensure we are thinking holistically about risk to buyers, sellers, ... and Amazon with every new policy , product launch, and program update. The scope for...brilliant, hard-working, resilient, fun, energetic, diverse, and prioritizes personal health and wellness above all else. This role is… more
- Serco (Washington, DC)
- …matter expertise in medical records review of the Medicaid and Children's Health Insurance Program claims . The position is responsible for the advising on ... insurance industry, a utilization review firm, or another health care claims processing organization involving medical and coding reviews of a variety of… 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
- Serco (Washington, DC)
- **Position Description** Serco is seekinga motivated Medical Records Manager for Medical Claims Review to join our talented and fast-paced Public Sector ... in direct communication with the Assistant Program Director for Medical Claims Review in managing medical... medical records and the electronic transmission of medical records; + Certification as a Registered Health… more
- Serco (Washington, DC)
- …A minimum of three (3) years of experience in a supervisory or managerial role in medical claims or clinical data management; + A minimum of five (5) years ... enrollment. + Knowledge and expertise in working with states' claims processing systems (including MMIS), payment policy ,... insurance industry, a utilization review firm, or another health care claims processing organization. + An… more
- Serco (Washington, DC)
- …+ Be in direct communication with the Program Director, Assistant Program Director for Medical Claims Review, Data Processing Reviewers, and CMS PERM staff, as ... program, particularly the coverage, conditions of payment, and state-specific policy requirements for health care coverage and...three (3) years of supervisory or managerial experience in medical claims or clinical data management; +… 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
- Serco (Washington, DC)
- …and/or CHIP program, particularly the coverage, conditions of payment, and state-specific policy requirements for health care coverage and payment; + Experience ... contract which includes collection of state eligibility policies and medical records; eligibility reviews, medical reviews, and... insurance industry, a utilization review firm, or another health care claims processing organization; + An… more