- Mass Markets (Killeen, TX)
- …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
- AssistRx (Phoenix, AZ)
- …claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication , troubleshoot claim ... The Copay Support/ Claims Processing Specialist is a critical...discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and… more
- CVS Health (TX)
- …inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …career advancement to all our team members. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing ... Adjudication Specialist Job Details Job Location...and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims… more
- Providence (Mission Hills, CA)
- **Description** The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per ... diem, case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they… more
- Sedgwick (Honolulu, HI)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist , General Liability (Property) **PRIMARY PURPOSE** : To analyze ... exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and… more
- Ascension Health (Austin, TX)
- …and accurately, in accordance with regulatory requirements. + Strong understanding of claims adjudication process, provider contracts, fee schedules and system ... Additional Preference: + Three (3) years of experience in health-care claims adjudication required. + Expertise in the Facets platform preferred. + Experience… more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... 011250 CCA- Claims Hiring for One Year Term **_This position...the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
- Allied Solutions (Plano, TX)
- …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
- New York State Civil Service (Queens, NY)
- NY HELP Yes Agency Workers' Compensation Board Title Compensation Claims Referee (NY HELPS), WCB Item #3845 Occupational Category Legal Salary Grade 28 Bargaining ... Telecommuting allowed? Yes County Queens Street Address Office of General Counsel, Adjudication Services 168-46 91st Avenue 3rd Floor City Queens (Jamiaca) State NY… more
- Dignity Health (Bakersfield, CA)
- …advanced-level role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims . This position requires expert ... knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and… more
- UNUM (Chattanooga, TN)
- …level technical position responsible for the thorough, fair, objective, and timely adjudication of the most complex short-term disability claims in conjunction ... providers. **Principal Duties and Responsibilities:** + Timely and accurate adjudication of complex STD claims + Processing...or more years in the Leave or Disability Benefit Specialist role + Mastery of all key responsibilities and… more
- Community Health Systems (Birmingham, AL)
- As a Billing Specialist at Grandview Medical Group you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our ... and student loan assistance for eligible roles. **Job Summary** The Billing Specialist II is responsible for managing complex billing functions, ensuring timely and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Bluebird Bio, and Gift of Life accounts to ensure accurate reimbursement and final adjudication of claims as needed. Works prebilling edits in the billing and ... based on alphabetical splits. Responsibilities of the Patient Accounting Billing Specialist include regular and consistent billing for all payers and follow-up… more
- Robert Half Accountemps (Tampa, FL)
- …skills, combining compassion and attentiveness in interactions. * Familiarity with claims -related systems and processes, such as claim adjudication or ... Description We are looking for an Insurance Follow-Up Specialist to join our team in Tampa, Florida....to expedite claim processing. * Investigate delays in insurance claims and provide solutions with a proactive and detail-oriented… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- …support in the management of contractor requests for equitable adjustments and adjudication of contractor claims . Assists in developing documents for legal ... Title: Facilities Contract Specialist (Level I/II) Non-Competitive Progression Location: United States-Virginia-Virginia Beach Job Number: 250002P2 Are you ready to… more
- Movn Health (CA)
- …billing and A/R management + Deep knowledge of payer reimbursement methodologies and claims adjudication + Proficiency with multiple EHRs + Strong command of ... seeking a highly experienced Senior Medical Biller & A/R Specialist to take full ownership of claims ...A/R Specialist to take full ownership of claims processing and accounts receivable recovery. This is a… more
- US Army Corps of Engineers (Seattle, WA)
- …Business Administration, and state regulatory agencies. Oversee the processing of contract claims and disputes arising under the Contract Disputes Act. Oversee and ... about transcripts is in this document. Basic Requirement for Contract Specialist : Degree: Bachelor's degree (or higher degree) from an accredited educational… more
- Molina Healthcare (NE)
- …Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- Executive Office for Immigration Review (Eloy, AZ)
- …Office for Immigration Review, U. S. Department of Justice. The Legal Administrative Specialist provides a range of legal support functions to include review and ... 90 days of certificate issuance. Responsibilities As a Legal Administrative Specialist (In-Court Services) GS- 0901-9/11, your typical work assignments may include… more