- Serco (Washington, DC)
- …characteristics. Click here to apply now (https://careers-sercous.icims.com/jobs/63792/ health - policy - medical - claims ... Description** Serco is seekinga motivated Assistant Program Director for Medical Claims Review to join our talented...claims processing review for the Medicaid and Children's Health Insurance Program. The position also is responsible for… more
- Guardian Life (Washington, DC)
- …Meet productivity requirements as established by department for handling Supplemental Health Claims . Leadership Behaviors + Demonstrates intellectual curiosity. ... have + Experience of 3 plus years processing Supplemental Health claims . (Accident, Critical Illness, Cancer and...flexible, and inclusive benefits and resources to our colleagues. ** Health Care** + Choice of [high deductible/copay] medical… more
- Travelers Insurance Company (Chantilly, VA)
- …input and shares ideas. + Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. ... resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- HomeSafe Alliance (Arlington, VA)
- **Title:** Claims Adjuster (SCA) HHG/Military Move **HomeSafe Alliance** is the single global household goods movement manager of over 300,000 Military Household ... an SCA position** . **Position Summary** : **HomeSafe Alliance** is seeking experienced Claims Adjustors with experience in HHG/Military Move to process and settle … more
- Ryder System (Washington, DC)
- …Job Applicant Privacy Policy by clicking HERE. (https://ryder.com/job-applicant-privacy- policy )\_ **Summary** The Claims Representative handles complex and ... salary for this position ranges from $70,000-$75,000 annually Ryder offers comprehensive health and welfare benefits, to include medical , prescription, dental,… more
- Sedgwick (Alexandria, VA)
- …regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Auto **PRIMARY PURPOSE** : To analyze...are properly documented and correctly coded based on the policy . + Develops and maintains action plans to ensure… more
- Lincoln Financial Group (Washington, DC)
- …at a Glance** We are excited to bring on highly motivated Short Term Disability Claims Specialists to staff our ever-growing claims organization. As a Short Term ... conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You'll… more
- Lincoln Financial Group (Washington, DC)
- …**The Role at a Glance** We are excited to bring on highly motivated Leaves Claims Specialists to staff our ever-growing claims organization. As a Leaves ... responsible for administering and managing leave requests relating to the Family and Medical Leave Act (FMLA), the Americans with Disabilities Act (ADA) as well as… more
- Serco (Washington, DC)
- **Position Description** Serco is seekinga motivated Policy Specialist for Medical Claims Review to join our talented and fast-paced Public Sector Solutions ... national reporting; and development of corrective actions based on review findings. The Policy Specialist for Medical Claims Review position would support… more
- Serco (Washington, DC)
- …unique combination of strong program management experience and subject matter expertise in medical records review and claims processing review for the Medicaid ... critical issues and program improvements to coordinate and optimize multiple aspects medical and claims review operations. **_Hybrid or full-time remote work.… more
- Serco (Washington, DC)
- **Position Description** Serco is seekingseveral motivated Eligibility Policy Analysts to join our talented and fast-paced Public Sector Solutions team in supporting ... Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as required by the… more
- Highmark Health (Washington, DC)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... work. + Calculate rates, employ different financial arrangements, interpret pricing policy and adapt to unusual situations. + Identify questionable claim patterns… more
- Highmark Health (Washington, DC)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... staff. + Calculate rates, employs different financial arrangements, interprets pricing policy and adapts to unusual situations. + Identify questionable claim… more
- Serco (Washington, DC)
- …A minimum of three (3) years of experience in a supervisory or managerial role in medical claims or clinical data management; + A minimum of five (5) years ... enrollment. + Knowledge and expertise in working with states' claims processing systems (including MMIS), payment policy ,... insurance industry, a utilization review firm, or another health care claims processing organization. + An… more
- Serco (Washington, DC)
- …+ Be in direct communication with the Program Director, Assistant Program Director for Medical Claims Review, Data Processing Reviewers, and CMS PERM staff, as ... program, particularly the coverage, conditions of payment, and state-specific policy requirements for health care coverage and...three (3) years of supervisory or managerial experience in medical claims or clinical data management; +… more
- Travelers Insurance Company (Chantilly, VA)
- … with lost time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a ... Medical Case Manager. Independently handles assigned claims ...+ Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical … more
- Serco (Washington, DC)
- …and/or CHIP program, particularly the coverage, conditions of payment, and state-specific policy requirements for health care coverage and payment; + Experience ... contract which includes collection of state eligibility policies and medical records; eligibility reviews, medical reviews, and... insurance industry, a utilization review firm, or another health care claims processing organization; + An… more
- Trinity Health (Aspen Hill, MD)
- …Required:** High school graduate possessing two () years experience in accounting and medical claims management, preferably in a hospital or physician's office ... hospitals limited community benefit resources by implementing the financial assistance policy with fairness and accuracy. Resolve patient's billing concerns via the… more
- Westat (Rockville, MD)
- …team on a variety of health services research projects focused on health care delivery, payment, and policy . Remote work arrangement available. **Job ... claims and assessment data, + Demonstrated experience conducting health services research independently and on multidisciplinary teams. + Demonstrated experience… more
- Elevance Health (Washington, DC)
- …equivalent background. + Health insurance experience required with understanding of health insurance policies, health insurance claims handling and ... ideal candidate will live within 50 miles from one of our posted Elevance Health locations._ Carelon Payment Integrity is a proud member of the Elevance Health… more