- Sedgwick (Louisville, KY)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation (REMOTE - Southeast State Exp Required) ... **PRIMARY PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims … more
- Sedgwick (Frankfort, KY)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... process complex auto and bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
- Intermountain Health (Frankfort, KY)
- **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely… more
- Molina Healthcare (Lexington, KY)
- …or GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 1-3 years' experience in claims adjudication, Claims Examiner II, or other relevant work ... **Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines,… more
- Sedgwick (Frankfort, KY)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- City of Henderson (Henderson, KY)
- …employment + Latent Print/Footwear Discipline: Must possess the Latent Print Examiner certification or Footwear Examiner certification through the International ... physical requirements of the job. As part of the background investigation, all claims of education and experience made in the employment application process, as well… more
- Sedgwick (Frankfort, KY)
- …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... to advance to the next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation for… more
- Prime Therapeutics (Frankfort, KY)
- …and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively ... compliance with federal, state and local laws pertaining to investigations and fair claims handling practices; evaluate risk to determine how best to proceed with… more
- Prime Therapeutics (Frankfort, KY)
- … claims processing environment **Preferred Qualifications** + Certified Fraud Examiner or Accredited Health Care Fraud Investigator + National Pharmacy Technician ... and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current on… more
- Highmark Health (Frankfort, KY)
- …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more
- Molina Healthcare (KY)
- …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you are interested in… more