- Sedgwick (Harrisburg, PA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Consumer Claims Representative **PRIMARY PURPOSE** **:** To analyze ... to make timely payments and adjustments for specified program claims including high value and complex claims ;...program claims including high value and complex claims ; to coordinate investigative efforts; to thoroughly review contested… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Claims Review Representative 3 makes appropriate claim decision based on strong knowledge ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative 3 performs advanced administrative/operational/customer… more
- Highmark Health (Harrisburg, PA)
- …to provide office based, hands-on assistance services (ie, chart reviews, mass claims adjustments, UDC processes, etc.) to PCPs enrolled in Medicare STARS, Medicaid ... STARS, Medicaid HEDIS, risk revenue). + Function as the Organization's representative subject matter expert in government value-based reimbursement programs and data… more