- Commonwealth of Pennsylvania (PA)
- Medical Malpractice Claims Examiner 2 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4927741) Apply Medical Malpractice Claims ... Experience and Training Requirements: + One year as a Medical Malpractice Claims Examiner 1 (Commonwealth job title or equivalent Federal Government job title,… more
- Sedgwick (Harrisburg, PA)
- …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 (Harrisburg, PA)
- **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
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Examiner - Fast Track Auto to join our team! Summary: Investigate and analyze ... insurance claims to determine extent of Insurer's obligations. Settle claims with first and third party claimants in accordance with policy provisions and… more
- Commonwealth of Pennsylvania (PA)
- …for this exciting opportunity today! DESCRIPTION OF WORK As a Medical Records Examiner , you will review records, documents, and claims submitted by enrolled ... Medical Records Examiner Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4928672) Apply Medical Records Examiner Salary $66,250.00 -… more
- Sedgwick (Harrisburg, PA)
- …Suite 100, Austin, TX 78758.** **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and operational expense… more
- Sedgwick (Pittsburgh, PA)
- …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
- Centene Corporation (Harrisburg, PA)
- …teams as needed. + Supports the provider escalation project team to resolve claims and payment issues. + Identifies root-cause issues to ensure enterprise solutions ... best practice and quality standards. + Applies a comprehensive knowledge of claims processing, provider customer service and payment knowledge to escalated provider… more
- Prime Therapeutics (Harrisburg, PA)
- …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 (Harrisburg, PA)
- … 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 (Harrisburg, PA)
- …**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