- Serco (Washington, DC)
- **Position Description** Serco is seekinga motivated Assistant Program Director for Medical Claims Review to join our talented and fast-paced Public Sector ... of corrective actions based on findings. The Assistant Program Director for Medical Claims Review would be responsible for management the medical… more
- Robert Half Office Team (Sacramento, CA)
- Description Robert Half Healthcare is looking for a dedicated and detail-oriented Medical Claims Specialist to join our team and help us maintain our high ... standard of service. As a Medical Claims Specialist you will play a...will be essential in this role. Key Responsibilities: + Review and verify patient information, medical codes,… more
- CVS Health (Tallahassee, FL)
- …innovate and deliver solutions to make health care more personal, convenient and affordable. The Medical Claims Adjuster will review and adjust claims ; ... resource materials to manage job responsibilities. Required Qualifications: + 2+ years Medical claims processing experience + Demonstrated ability to handle… more
- CVS Health (Lansing, MI)
- …innovate and deliver solutions to make health care more personal, convenient and affordable. The Medical Claims Adjuster will review and adjust claims ; ... dollar amount level on customer service platforms by using technical and claims processing expertise. * Applies medical necessity guidelines, determine coverage,… more
- Robert Half Accountemps (Novi, MI)
- …Stressful conditions may arise when workload becomes more demanding than normal. Requirements Claims Processing, Medical Claims Robert Half is the world's ... process per approved client-specific telephonic scripts. * Track scheduled incoming claims documents for timeliness, as applicable (eg medical records; initial… more
- Insight Global (Somerset, NJ)
- Job Description Insight Global is looking for a Medical Claims Biller for one of our healthcare clients in Somerset, NJ. The candidate will oversee calculating ... reimbursed for the specific healthcare service provided. They must have experience following medical claims and updating patient data. The candidate should also… more
- Ascension Health (Orange Park, FL)
- **Details** + **Department:** Medical Claims Processing Urology + **Schedule:** Day Shift Monday - Friday 8:00am - 5:00pm + **Facility:** Ascension St. Vincent's ... individual and third party payers in an out-patient or medical office environment. + Prepare insurance claims ...submission to third party payers and/or responsible parties. + Review claims for accuracy, including proper diagnosis… more
- Crawford & Company (FL)
- …the processing of the claim. + Identifies wage loss expenses and wage exposures on medical claims . + Documents receipt and contents of medical reports. ... exceeding, $2,500 after compensability has been determined. + Evaluates medical claims for potential fraud issues, loss...carrier guidelines and prepares written updates for supervisor to review . + Performs other related duties as required or… more
- WelbeHealth (CA)
- …on the aptitude to work independently, adhere to timelines, and comprehend intricate medical claims . **Essential Job Duties:** + Oversee the workings of our ... seniors stay in their homes and communities by providing medical care and community-based services. Our core values and...be accountable for managing second level provider disputes, the review and resolution of claims related issues,… more
- Sedgwick (Roseville, CA)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Adjuster | Long Beach or Roseville, CA **PRIMARY PURPOSE** **:**… more
- Sedgwick (Las Vegas, NV)
- …properly documented and claims coding is correct. + May process low-level lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative Workers Compensation **PRIMARY PURPOSE** : To process low level… more
- Sedgwick (King Of Prussia, PA)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Adjuster/Examiner Liability **PRIMARY PURPOSE:** To analyze mid- and higher-level… more
- Sedgwick (Pasadena, CA)
- …properly documented and claims coding is correct. + May process low-level lifetime medical and/or defined period medical claims which include state and ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Representative Are you looking for an opportunity to join a global… more
- Sedgwick (Baton Rouge, LA)
- …are properly documented and claims coding is correct. May process low-level lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Workers Compensation **PRIMARY PURPOSE:** To process low level… more
- Sedgwick (San Juan, PR)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Adjuster- Multi Line (Bilingual - Spanish/English) **PRIMARY PURPOSE** : To… more
- State of Minnesota (Bemidji, MN)
- …the following areas relevant to Veterans benefits, Veterans programs, or disability/ medical claims : + Interviewing claimants + Investigating/researching ... **Working Title** : **Tribal Veterans Services Officer** **Job Class: Veterans Claims Representative** **Agency: Minnesota Department of Veterans Affairs** + **Who… more
- UCLA Health (Los Angeles, CA)
- …for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of ... * High school diploma, GED or equivalent * Minimum five years of medical claims payment experience in an HMO environment * Experience with CPT-4, ICD-9CM, RBRVS,… more
- CVS Health (Hartford, CT)
- …CT required Claim Supervisor: Responsible for the overall supervision of Medical Claim Processing employees. Achieve superior service performance through an ... integrated process of operational, quality, medical cost and resource management tools and applications; meeting...evaluate and coach staff to provide cost effective claim review /processing and claim service while ensuring compliance and quality… more
- TEKsystems (Fresno, CA)
- … Claims . Claims Examiner I is responsible for reviewing and processing medical , dental, vision and electronic claims in accordance with state, federal and ... Health Insurance Payment Demand (HIPD) claims . The Claims Examiner I will thoroughly review , analyze,...* A minimum of one (1)year experience as a Claims Examiner for medical , dental claims… more
- Sedgwick (Columbus, OH)
- …adjustments for specified program claims including high value and complex claims ; to coordinate investigative efforts; to thoroughly review contested ... FUNCTIONS and RESPONSIBILITIES** + Manages first party property, casualty and/or medical reimbursement claims based on multiple/additional coverage and/or… more