- TEKsystems (Honolulu, HI)
- The Benefits Lead will oversee claims processing operations, ensuring accuracy, efficiency, and compliance with regulatory requirements. This role requires a ... management capabilities, and a drive for process improvement. This Lead will manage both onshore and offshore vendor relationships...will reach out to you. Responsibilities + Oversee end-to-end claims processing operations + Track testing, and… more
- UCLA Health (Los Angeles, CA)
- …and regulatory standards. You will: + Coordinate and monitor the daily workflow of claims processing . + Distribute unprocessed claims from the Claims ... Description As a Claims Compliance Lead , you will play...role in in ensuring the timely, accurate, and compliant processing of health insurance claims . The ideal… more
- AIG (Jersey City, NJ)
- …technology is at the heart of everything we do, from underwriting risks to processing claims . The Information Technology team equips our colleagues with the ... we help customers to manage risk. Join us as Assistant Vice President Claims Application Technical Lead , Global Claims Technology to play your part in that… more
- Prime Therapeutics (Bismarck, ND)
- …fuels our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit ... and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify...and administrative duties as required by business need. + Lead and implement positive changes with a high level… more
- TEKsystems (Honolulu, HI)
- Description The Claims Manager will oversee the claims processing operations, ensuring accuracy, efficiency, and compliance with regulatory requirements. ... lines of business, including Medicare, Medicaid, and commercial insurance. Key Responsibilities: Claims Processing : Oversee the end-to-end claims … more
- TEKsystems (Honolulu, HI)
- …a local company seeking a Claims Manager will oversee the claims processing operations, ensuring accuracy, efficiency, and compliance with regulatory ... recruiter will reach out to you. Key Responsibilities: + Claims Processing : Oversee the end-to-end claims...to enhance operational efficiency and accuracy. + Team Management: Lead and mentor a team of ICT testers and… more
- Dignity Health (Bakersfield, CA)
- … Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves ... Qualifications:** + Minimum of 5 years of experience in claims processing , quality assurance, or a related...of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population… more
- ICW Group (San Diego, CA)
- …ensuring it aligns with overall business objectives. This includes balancing effective claims processing with risk mitigation. The CCO develops policies, ... and trends to identify areas for improvement and implement strategies to enhance claims processing efficiency and effectiveness. + Develops and implements online… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Master's Degree Experience Required: A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal ... Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in...capitated hospitals and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.… more
- Beth Israel Lahey Health (Boston, MA)
- …test and build of system upgrades or changes that effect claims processing and cash posting. + Lead continuous improvement efforts, proactively identifying ... support business objectives. + Implementation and testing of regulatory requirements affecting claims processing and cash posting including adherence with the… more
- Centers for Independence (Milwaukee, WI)
- …perform these essential functions.) + Oversees daily operations related to claims processing , EVV verification, timesheet correction, payroll batch management, ... **Operations Supervisor - Claims and EVV** **Job Details** **Job Location** iLIFE...Operations Supervisor partners with internal and external stakeholders to lead agency success. This role supports, guides, and mentors… more
- HCA Healthcare (Nashville, TN)
- …Physician's Services Group and other corporate departments that will mutually benefit the Claims Department and the organization. + Lead and/or participate in ... an organization that invests in you as a Sr Claims Supervisor? At HCA Healthcare, you come first. HCA...assigned jurisdictions required + Proficient computer skills with word processing and database competency required + Possess critical thinking,… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** ** Claims Analyst** **Location:** Trinity Health PACE Corp Michigan, Livonia, MI **Status:** Full time ... **Type:** HYBRID, will work in the office each Wednesday. **Position Purpose:** The Claims Analyst is responsible for analyzing and reviewing claims for… more
- Golden State Foods (Irvine, CA)
- …and oversees claims handling procedures and program enhancements to streamline claims processing and mitigate loss + Manage quarterly claim review with ... or university. + 5-7+ years of progressive experience as an Insurance Claims Adjustor, TPA Team Lead , or Corporate Risk Manager with a high acuity for workers… more
- Kelly Services (Ontario, CA)
- …schedule: **2 days in-office** , with first **3 days required on-site for training** + Lead a team of **6 experienced claims examiners** **What's a typical day ... Supervisor? You'll be:** **Essential Duties and Responsibilities** + Analyzing and processing complex or technically difficult workers' compensation claims +… more
- Citizens (Glen Allen, VA)
- …and customer experience. + Support incident triage and production issues related to claims processing tools and workflows. + Ability to understand , read ... seeking a strategic and customer-focused Product Owner with deep expertise in claims management across both front office (customer-facing channels) and back office… more
- CHS (Clearwater, FL)
- … claims prior to payment. * Oversight for the ongoing management of claims processing technology, including plan building and identification of new and ... the client's stated coverage. Join Premier Administrative Solutions as a Claims Manager and lead our Claims Department in delivering exceptional service to… more
- CHS (Clearwater, FL)
- …guidelines, and reporting requirements; Federal and state regulations; and timeliness of claims processing . + Utilize Excel, prepares tracking and trending ... up-to-date working knowledge on regulatory requirements associated with billing and claims processing , as well as HIPAA guidelines/established Encryption… more
- Elevance Health (Columbus, GA)
- …interactions provided by organizations within the enterprise. Included are processes related to claims processing , as well as written and verbal inquiries. **How ... Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member...interpretation of guidelines and audit process. + Facilitate and lead meetings with business to review audit plan, audit… more
- US Tech Solutions (Columbia, SC)
- …**Required Work Experience** : 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work ... research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny...desk procedures and guidelines and refers these to a lead or manager for resolution. + Identifies and reports… more