- AssistRx (Phoenix, AZ)
- …Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim ... duplicates) + Partners with claim adjudication vendors ensure proper claims processing and data integrity. + Monitor and remediate medical and pharmacy… more
- MyFlorida (Tallahassee, FL)
- CLAIMS PROCESSING SUPERVISOR - 36000333 Date:...to team members. Assist in preparing the How to Claim web page information for all new promotions. + ... . Requisition No: 866202 Agency: Department of Lottery Working Title: CLAIMS PROCESSING SUPERVISOR - 36000333 Pay Plan: Lottery Exempt Serv Position Number:… more
- IQVIA (New Providence, NJ)
- **Patient Support Medical Claims Processing Representative** _Remote Role - Location (Open to Remote US)_ As the only global provider of commercial solutions, ... 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team....+ High School Diploma or equivalent + Experience in claim processing required + Medical Billing Certification… more
- Boston Mutual Life Insurance (Canton, MA)
- …Executive Vice President of Customer Experience. This role will also manage our external claims partners. ** Claim Processing ** : + Directs and oversees the ... handling of all insurance claims . + Ensure timely and accurate claim processing . + Implements processes and procedures for all aspects of claims . +… more
- MVP Health Care (Rochester, NY)
- …and Macess Systems. + Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + ... continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a...Reviews and ensures the accuracy of all changes to claim line information based on information received from other… more
- Ryder System (Augusta, ME)
- …claims within Ryder's self-insured, self-administered liability program. Oversees claim -handling processes performed by a professional staff. Handles complex ... action plans if deficiencies are noted. Monitors staff's workflow to ensure accurate processing of claims , timely establishment of reserves, reviews and logs… more
- AIG (Lenexa, KS)
- …party contractors or by internal claim handling teams associated with the processing of commercial or personal line claims . + Generate monthly reports that ... need to succeed + Proven claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience is… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims processing to join our team in Plano, Texas (US-TX), United ... In these roles you will be responsible for: Review and process insurance claims . Validate Member, Provider and other Claim 's information. Determine accurate… more
- Travelers Insurance Company (San Diego, CA)
- …As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer ... claims handling process **What Will You Do?** + Provide quality claim handling of auto claims including customer contacts, coverage, investigation,… more
- Sedgwick (Plano, TX)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Molina Healthcare (Buffalo, NY)
- …updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these ... communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims … more
- Travelers Insurance Company (West Bridgewater, MA)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site...mail. Orders, receives and distributes supplies and/or equipment. + CLAIM PAYMENTS AND EXPENSE PROCESSING : Ensures the… more
- Providence (Mission Hills, CA)
- …of functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. ... Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- CVS Health (Tallahassee, FL)
- …+ 3+ years of experience in medical billing and coding, specifically related to claims processing and root cause analysis. + 3+ years of experience with ... non-participating providers. Additionally, they will assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Claims Processing + **Schedule:** Full Time, Days + **Facility:** Ascension Medical Group + **Location:** Jacksonville, FL ... party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review … more
- CVS Health (Hartford, CT)
- … claim or reconsideration. **Required Qualifications** - 18+ months of medical claim processing experience. - Experience in a production environment. - ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- CVS Health (Franklin, TN)
- …Description **A Brief Overview** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. **What ... timely support. + Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing...Minimum Requirements** + 2+ years of experience with medical claim processing . + 2+ years of experience… more
- Trinity Health (Livonia, MI)
- …behavior. **MINIMUM QUALIFICATIONS** Must possess a comprehensive knowledge of liability claims processing and administration. High school diploma plus a ... coordinating claim process activities, opening and closing claim files, securing medical records for claims ...closing claim files, securing medical records for claims and incidents, tracking claim expenses and… more
- Highmark Health (Topeka, KS)
- …and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, ... **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health… more
- Sedgwick (Miami, FL)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more