- University of Washington (Seattle, WA)
- …Medicine Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is ... responsible for claims review, clearing claim edits, and timely and accurate...information, posting rejections, or forwarding the claim to a medical coding specialist for review and coding… more
- Philadelphia Insurance Companies (Seattle, WA)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Specialist to join our team! Summary: Investigate, evaluate and settle more complex first ... and third party commercial auto insurance claims . A typical day will include the following: Thoroughly understands coverages, policy terms and conditions for broad… more
- Molina Healthcare (Everett, WA)
- …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment is ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- Terumo Medical Corporation (Seattle, WA)
- …the Cath Lab or Interventional Radiology environment. Prior experience as a Field Clinical Specialist with a medical device company is preferred. It is Terumo's ... Field Clinical Specialist , Seattle North Date: Nov 4, 2025 Req...Req ID: 5306 Location: Seattle, WA, US Company: Terumo Medical Corporation Department: TIS Sales - Big Sky Terumo… more
- University of Washington (Seattle, WA)
- …Plan Services (FPPS)** has an outstanding opportunity for an **Insurance Follow-Up Specialist ** to join our **Medicare** team **.** **WORK SCHEDULE** + 100% FTE ... + Mondays - Fridays + 100% Remote **POSITION HIGHLIGHTS** The **Insurance Follow-Up Specialist , Medicare** is responsible for the optimal payment of claims from… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... ensure that internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise Act** cases… more
- Otsuka America Pharmaceutical Inc. (Seattle, WA)
- …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. In ... its evolved customer engagement model, a Neuroscience Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools, offering expertise… more
- Molina Healthcare (Everett, WA)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to… more
- CDM Smith (Seattle, WA)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
- PDS Defense (Seattle, WA)
- **Light Industrial/Manufacturing** **Supply Chain Specialist 1** Seattle, WA Posted: 11/14/2025 Job Description Job ID#: 213436 Job Category: Light ... Shift: 1 Positions Available: 2 **PDS Defense, Inc. is seeking a Supply Chain Specialist 1, in Seattle, WA. Job ID#213436** **Pay Rate: $31 - $36/hr** **Job… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating ... information system and prepares documentation for further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness… more
- The Boeing Company (Everett, WA)
- …future with us. The Boeing Company is seeking a **Mid-Level Disability Management Specialist ** based out of **Everett, WA.** This position will support the Everett ... management and employees to initiate and facilitate interactive discussions for medical restrictions and qualifications + Identifies crucial job functions and… more
- Molina Healthcare (Everett, WA)
- …care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases ... to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and associated records by… more
- Molina Healthcare (Everett, WA)
- …to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of ... to present those findings. **Preferred License, Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified… more
- Elevance Health (Seattle, WA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... claims . **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- Molina Healthcare (Seattle, WA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems ... MHI attorney. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on… more
- Molina Healthcare (Everett, WA)
- …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific… more
- UIC Government Services and the Bowhead Family of Companies (Everett, WA)
- …DoD networks. + Required skills or certifications + Avaya Certified Support Specialist (ACSS) or equivalent + Nortel Meridian System Administration or equivalent + ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- Bristol Myers Squibb (Bothell, WA)
- …Health Senior Manager will oversee and provide nursing services including medical surveillance and fitness for duty examinations, travel assessments, occupational ... injury / illness care, case management (eg medical accommodations, workers compensation), and acute care for episodic non-occupational injuries/illnesses at Bristol… more