- The Computer Merchant, LTD. (West Mclean, VA)
- …of Facets and their integration within payer systems. Proven expertise in Claims Adjudication and Processing. JOB DESCRIPTION: As an QNXT/Facets Developer at Client, ... and motivating a team of product development experts to meet deadlines and deliver high- quality products to clients What we're looking for 8+ years of experience in… more
- Centene Corporation (Jefferson City, MO)
- …functions of staff members to assure a smooth and timely work flow. + Manage the Claims Quality Analysts to perform quality review of completed high risk ... and facilitate identified customer needs and escalated issues and inquiries. + Track claims quality trends and review Internal Audit claims quality … more
- AIG (Atlanta, GA)
- Claims , Quality Assurance Specialist - Worker's Compensation Join us as a Claims QA Specialist to make more of your specialist expertise and experience. Make ... your mark in Claims . Our Claims teams are the proven...efficiency. How you will create an impact + Complete quality reviews on all files within program guidelines while… more
- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- PennyMac (Moorpark, CA)
- …aspirations of homeownership through the complete mortgage journey. A Typical Day The Quality Assurance (QA) Claims Processor will perform QA reviews in ... required by the applicable investor and insurer servicing guidelines. The QA Claims Processor will : + Reconcile servicing expenses/corporate advances as required by… more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Global Quality Assurance Reviewer - Claims to play your part in that transformation. It's ... valued member of the team. Make your mark in Claims Stewardship Our Claims professionals support AIG...environment. How you will create an impact The Global Quality Assurance team is looking to recruit a talented… more
- Molina Healthcare (Buffalo, NY)
- …* Adjudicates or readjudicates claims in a timely manner. * Meets claims department quality and production standards. * Supports claims department ... JOB DESCRIPTION Job Summary Provides support for claims adjustment activities including administering claims payments, maintaining claim records, and providing… more
- Molina Healthcare (Omaha, NE)
- …communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims ... JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching,… more
- Molina Healthcare (Spokane, WA)
- …documents/images for multiple health plans using multiple applications. * Meets claims department quality and production standards related to administrative ... JOB DESCRIPTION Job Summary Provides entry level support for claims recovery activities. Responsible for claims data entry, inbox monitoring, and documentation… more
- Molina Healthcare (Cedar Rapids, IA)
- …department initiatives to improve overall claims function efficiency. * Meets claims department quality and production standards. * Completes basic claims ... JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and...outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled… more
- Zurich NA (Schaumburg, IL)
- …points of contact including customers, vendors, suppliers, and brokers to provide a quality claims experience. Additionally, you will learn and develop knowledge ... are handled in the most efficient, effective way while delivering a quality customer-centric claims experience. This position will work from one of the following… more
- AIG (Jersey City, NJ)
- …How you will create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims ... Claims Complex Director - Healthcare Professional Liability (HPL)...internal coordination with the corporate legal team. + Achieves quality standards by effectively managing each claim to ensure… more
- Sedgwick (Birmingham, AL)
- …and documentation standards. . Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation (REMOTE - FL...experience to supervise a team that adjudicates complex customer claims in the context of an energetic culture. .… more
- Sedgwick (Richmond, VA)
- …and documentation standards. . Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation (REMOTE) ** Jurisdiction...brands?** . Apply your knowledge and experience in a claims leadership role in the context of an energetic… more
- Zurich NA (Addison, TX)
- …points of contact, including customers, vendors, suppliers, and brokers, to provide a quality claims experience. + Learn and develop knowledge of established ... General Liability Claims Specialist I 129754 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to… more
- AIG (New York, NY)
- …on the portfolio. + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ensuring mitigation ... Job Description Join us as a Claims Analyst III to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim… more
- Molina Healthcare (Syracuse, NY)
- … department initiatives to improve overall claims function efficiency. + Meets claims audit department quality and production standards. + Completes basic ... JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste,… more
- Sedgwick (Riverside, CA)
- …and documentation standards. + Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation | Hybrid -...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- Sedgwick (Springfield, IL)
- …and documentation standards. + Providing technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for ... Fortune Best Workplaces in Financial Services & Insurance Assistant Claims Team Lead - Workers Compensation Are you looking...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- AIG (New York, NY)
- …will be expected to utilize existing relationships internally and externally to ensure Claims provides high quality training opportunities not only to new hires ... manage risk. Join us as Business Manager, North America Claims to play your part in that transformation. It's...valued member of the team. Make your mark in Claims Our Claims teams are the proven… more
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