- NTT DATA North America (Ontario, CA)
- NTT DATA is currently seeking ** Senior Medical Claims Examiners (3+ years of Xcelys required)** to join our US based team. This is a 100% remote role. ... **Purpose** To serve as a senior -level adjudicator and SME for medical claims within the Xcelys environment. Provide subject-matter expertise on claims … more
- NTT DATA North America (Ontario, CA)
- …for a 3 month contract role. Start Date: ASAP 100% Remote **Team Lead** -for Senior Claims Examiners on Xcelys System **Job Summary** The Xcelys Team ... overall sourcing strategy. NTT DATA Services currently seeks Xcelys Medical Claims Team Lead to join our...examiners , ensuring the accurate and timely processing of medical claims using the Xcelys system. The… more
- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner ** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical ... Claims Examiner adjudicates medical claims based on health policy provisions and established guidelines....appropriateness, eligibility and coordination of benefits + Documents fully claims referred to senior staff for review… more
- NTT DATA North America (Ontario, CA)
- ** Senior Claims Examiner (Xcelys...as a senior -level adjudicator and SME for medical claims within the Xcelys environment. Provide ... System)** **NTT DATA Services currently seeks a Senior Claims Examiner to join...**Key Duties & Responsibilities** -Adjudication & Review -Process comprehensive medical claims using Xcelys and associated subsystems… more
- US Tech Solutions (Whittier, CA)
- **Duration: 3+ months contract** **Responsibilities:** + Review, adjudicate, and process medical claims for HMO patients + Work closely with affiliated ... medical groups and hospitals + Evaluate provider reimbursement terms...forms + Understanding of provider contracts, Medi-Cal, commercial, and senior plan claims + Strong knowledge of… more
- State of Massachusetts (Boston, MA)
- …I| Department of Family & Medical Leave* The Program Integrity Claims Examiner /Job Service Representative I is responsible for supporting processes within ... the Department of Family Medical Leave (DFML). The Claims Examiner...Examiner /Job Service Representative I, who reports to the Senior Manager of Benefit Operations & Program Integrity is… more
- State of Massachusetts (Boston, MA)
- …II| Department of Family & Medical Leave* The Program Integrity Claims Examiner /Job Service Representative II is responsible for supporting processes within ... of Family Medical Leave (DFML). The Lead Claims Examiner /Job Service Representative II will review,...Examiner /Job Service Representative II, who reports to the Senior Manager of Benefit Operations & Program Integrity is… more
- Philadelphia Insurance Companies (Melville, NY)
- …as a member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr . Claims Examiner - PIP to join our team! Summary: Analyze insurance claims ... or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and… more
- Raphael and Associates (Rutherford, NJ)
- Senior Property Desk Examiner (remote) Company...currently growing and are looking for a TPA Property Claims Examiner with a minimum of five ... Overview: Raphael & Associates is a third-party claims administrator and independent claims adjusting company...opportunities! Job Summary: The work of our inside desk examiners directly contributes to the success of our organization.… more
- ICW Group (Pleasanton, CA)
- …better everyday! Learn more about why you want to be here! **PURPOSE OF THE JOB** The Senior Claims Examiner handles moderate to complex claims with a ... conclusion within Company standards and best practice guidelines. The Senior Claims Examiner works with...* We offer a competitive benefits package, with generous medical , dental, and vision plans as well as 401K… more
- AIG (Atlanta, GA)
- Join us as a Senior Claims Adjuster to grow your experience in handling Federal Workers Compensation claims . Make your mark in Claims Our Claims ... and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and ... claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most... processing, with at least 2 years in a senior or advanced role + Expert knowledge of CPT,… more
- Sedgwick (Brea, CA)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Liability Claims Examiner | Must Reside in CA Are you ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. _As required… more
- Patent and Trademark Office (Alexandria, VA)
- …patentability standards. Early in your career, you'll work closely with supervisors and senior examiners , receiving extensive guidance as you develop your skills ... shape what's next. Learn how to become a patent examiner , explore the patent examiner disciplines crosswalk...examination decisions, discuss them in depth with supervisors or senior examiners , and refine your work based… more
- Patent and Trademark Office (Alexandria, VA)
- …patentability standards. Early in your career, you'll work closely with supervisors and senior examiners , receiving extensive guidance as you develop your skills ... shape what's next. Learn how to become a patent examiner , explore the patent examiner disciplines crosswalk...examination decisions, discuss them in depth with supervisors or senior examiners , and refine your work based… more
- New York State Civil Service (Schenectady, NY)
- …Schenectady State NY Zip Code 12305 Duties Description Under the direction of a Senior Examiner , 18The position of Workers Compensation Examiner would be ... NY HELP Yes Agency Workers' Compensation Board Title Workers' Compensation Examiner (NY HELPS), WCB Item #8940 Occupational Category No Preference Salary Grade 14… more
- Marriott (Bethesda, MD)
- …via compliance and monitoring of self -insured/administered regulations and/or responsibilities. The Senior Director acts as a liaison between claims department ... promoting service excellence through education, training, and Service Call Program. The Senior Director follows and upholds the applicable claims sections of… more
- CHS (Clearwater, FL)
- … claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... claims and auto-adjudication. * Establishing production requirements for Examiners , and along with the Supervisor monitoring performance against the… more
- Sedgwick (Sacramento, CA)
- …strong background in insurance coverage analysis? We're seeking an experienced attorney or senior level examiner with a strong background in insurance coverage ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Complex Claims Advisor | Commercial GL and Auto | Remote Are you looking for an… more
- Houston Methodist (Houston, TX)
- …Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners , the Specialty Physician Group enables physicians to maintain ... and findings to both front line team members and senior executives. + Communicates to partners, revenue cycle staff,...**QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Analyzes data from various sources ( medical records, claims data, payer medical… more