• Kaiva Tech (Washington, DC)
    …and quality assurance standards. Participate in required training related to claims adjudication , program operations, and system usage. Maintain timely, ... Kaiva Tech, LLC is seeking Licensed Attorney - Claims Reviewer Location: Washington, DC Clearance: 5C Public Trust Position Type: Full-Time, Hybrid/Remote Position… more
    job goal (12/16/25)
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  • US Physical Therapy (Rome, GA)
    …Accurately and thoroughly document pertinent collection activity performed. + Verify claims adjudication utilizing appropriate resources and applications. + ... Initiate telephone and/or letter contact with parties responsible for reimbursement for services provided. + Edit/Update claim information to meet and satisfy billing compliance guidelines for electronic and paper claim submission. + Demonstrate knowledge of… more
    DirectEmployers Association (11/05/25)
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  • Wipfli LLP (Milwaukee, WI)
    …experience including knowledge in pre-authorization, pre-admission processes, denials management, claims adjudication , etc. + Provider compliance and ... reimbursement business process optimization experience including knowledge of edits, denials, holds, reimbursement, etc. + Senior living cost reporting data analysis knowledge of key performance indicators for reimbursement and national benchmarks + Experience… more
    DirectEmployers Association (11/03/25)
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  • BroadPath Healthcare Solutions (Tucson, AZ)
    …The Senior Claims Examiner's primary function is to ensure the accurate adjudication of all complex claims for SCCIPA contracted plans. Your expertise will ... **Overview** BroadPath is hiring a detail-oriented **Senior Claims Examiner** to train and work from home!...work from home! Join our team as a Senior Claims Examiner and play a crucial role in ensuring… more
    DirectEmployers Association (12/03/25)
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  • Rady Children's Hospital San Diego (San Diego, CA)
    …accurate adjudication of claim for reimbursement. They will process claims correctly following contractual arrangements the Medical Practice Foundation (MPF) has ... payors, including but not limited to; Commercial, Medi-Cal and Managed Care professional claims . This position is responsible checking status of unpaid claims by… more
    DirectEmployers Association (11/27/25)
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  • Claims Adjudication Specialist

    Mass Markets (Killeen, TX)
    …1-3 years of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a ... expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong… more
    Mass Markets (11/26/25)
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  • Senior Mainframe Developer (Healthcare…

    Cognizant (Lansing, MI)
    …**In this role, you will:** + Analyze user and business requirements for Claims domain and translate them into technical specifications and design documents that ... support our claims processing workflows, ensuring high-performance, accuracy, and regulatory compliance....File-aid and SCM is required. + Experience in healthcare claims and their associated systems is crucial for understanding… more
    Cognizant (12/17/25)
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  • Claims Specialist II

    AON (NY)
    Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your ... verbal and written communication. Skills that lead to success: + Claims adjudication experience. + Clear and professional written and verbal communication. +… more
    AON (11/04/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    …insurance companies, employers, and members. In this pivotal role, you'll oversee claims adjudication , drive operational strategy, and ensure high accuracy and ... clients. * Management of relationships with essential vendors involved with the Claims Adjudication process, including clearinghouses, claims cost control… more
    CHS (11/06/25)
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  • Claims Team Lead - Workers Compensation

    Sedgwick (Bartlesville, OK)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (12/18/25)
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  • Claims Team Lead - Liability (REMOTE- Must…

    Sedgwick (Baton Rouge, LA)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (12/17/25)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (Seatac, WA)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (12/13/25)
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  • Claims Examiner

    HCA Healthcare (Nashville, TN)
    claims , with at least one year of claims adjudication experience required Physician Services Group ... The ** Claims Examiner** primary function is to ensure correct adjudication of all claims for SCCIPA contracted plans. **DUTIES INCLUDE BUT NOT LIMITED TO:**… more
    HCA Healthcare (12/13/25)
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  • Claims Team Lead - Liability

    Sedgwick (Charlotte, NC)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. . Provides technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (12/03/25)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (Riverside, CA)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. + Provides technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (11/22/25)
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  • Assistant Claims Team Lead - Workers…

    Sedgwick (Springfield, IL)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. + Providing technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (11/21/25)
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  • Claims Team Lead | Auto Liability Bodily…

    Sedgwick (Indianapolis, IN)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/20/25)
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  • Workers Compensation Claims Team Lead | VA…

    Sedgwick (Norfolk, VA)
    …for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and ... liability claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and… more
    Sedgwick (11/07/25)
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  • Medicaid Claims Processing, Associate,…

    MVP Health Care (Schenectady, NY)
    …+ Meets or exceeds department quality and work management standards for claims adjudication . + Successfully completes a course of comprehensive formal ... available benefit information. + Is responsible for the timely and accurate adjudication of claims that are suspended to other MVP departments for benefit and/or… more
    MVP Health Care (12/19/25)
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  • Claims Examiner

    NTT America, Inc. (Plano, TX)
    …and work on weekend's basis business requirement. **Roles and Responsibilities:** + Process Adjudication claims and resolve for payment and Denials + Knowledge ... pre-established guidelines **Requirements:** + 1-3 years of experience in processing claims adjudication and adjustment process + Experience of Facets is an… more
    NTT America, Inc. (12/07/25)
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