- Mass Markets (Killeen, TX)
- …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
- AssistRx (Phoenix, AZ)
- …claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication , troubleshoot claim ... The Copay Support/ Claims Processing Specialist is a critical...discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and… more
- CVS Health (Franklin, TN)
- …to provide effective and timely support. + Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. ... **A Brief Overview** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. **What you will do**… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …most, we invite you to grow with us. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and ... customer trust and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims to determine… more
- AON (NY)
- …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 ... and written communication. Skills that lead to success: + Claims adjudication experience. + Clear and professional... Specialist II Do you have experience in claims adjudication and enjoy resolving issues for… more
- UPMC (Pittsburgh, PA)
- UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected ... Virginia workers comp adjuster license. The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims … more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- …perspective and experience makes ConnectiveRx better than the sum of its parts. The Claims Specialist , under the direction of the Supervisor (with guidance from ... such as EOBs, EOPs, SPPs, and pharmacy receipts. Information is entered into adjudication systems as required. Claims are paid or rejected based upon… more
- AIG (Lenexa, KS)
- …reimagining the way we help customers to manage risk. Join us as a Casualty Claims Specialist III to play your part in that transformation. It's an opportunity ... and efficiency. How you will create an impact The Claims Specialist III will handle auto and...that may involve litigation. The position also ensures ongoing adjudication of claims within the Company standards,… more
- Sedgwick (Fort Worth, TX)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Licensed Auto Claims Adjuster - Bodily Injury Specialist (New York License Required) ... claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify… more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... 011250 CCA- Claims Hiring for One Year Term **_This position...the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
- Allied Solutions (Plano, TX)
- …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
- Adecco US, Inc. (Jacksonville, FL)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Adecco is assisting a local client recruiting for ** Claims Examiner** opportunities **Remote** . This is an...Shift: 8 AM - 4:30 PM M-F Dedicated Onboarding Specialist & Recruiter Access to Adecco's Aspire Academy with… more
- Adecco US, Inc. (Washington, DC)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Adecco is assisting a local client recruiting for ** Claims Examiner Workers Compensation** opportunities in **Remote** ....AM - 4:30 PM M-F Weekly paycheck Dedicated Onboarding Specialist & Recruiter Access to Adecco's Aspire Academy with… more
- BlueCross BlueShield of North Carolina (NC)
- …are identified as trends/patterns of untimely, inaccurate, non-compliant, or inconsistent claims adjudication or messaging for our participating providers or ... are identified as trends/patterns of untimely, inaccurate, non-compliant, or inconsistent claims adjudication for our participating providers or partner BCBS… more
- Masonicare (Wallingford, CT)
- Billing Specialist Job Location: Wallingford Center, Connecticut Billing Specialist Masonicare Corporate Services - Wallingford, CT Day Shift / 40hrs/wk **THIS ... IS ON-SITE** Under general supervision from Patient Accounts Management, The Billing Specialist performs a variety of complex operations related to the eligibility,… more
- UPMC (Bridgeville, PA)
- …via telephone, e-mail and face to face required. + Knowledge of electronic claims adjudication and resolution required + Experience with prioritizing and ... is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides...dedicated team! This position provides prescription data entry and adjudication of claims under the supervision of… more
- AIG (Atlanta, GA)
- …service with empathy and efficiency. How you will create an impact The Specialist will handle and analyze general liability claims under general supervision ... claims involving litigation. The position also ensures ongoing adjudication of claims within the Company standards, industry best practices and specific… more
- TEKsystems (Los Angeles, CA)
- …reviewing medical claims to ensure accuracy, regulatory compliance, and proper adjudication . This role is ideal for a Licensed Vocational Nurse (LVN) or ... Job Title: Retro Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation:...reports, and present trends to leadership + Support automated adjudication systems and identify strategies to reduce errors +… more
- TEKsystems (West Des Moines, IA)
- …of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication + Work accounts in assigned queues in accordance with ... within Medicaid is required. Description The Insurance Billing and Follow Up Specialist II will be responsible for performing all billing and follow-up functions,… more
- UNC Health Care (Goldsboro, NC)
- …write-offs, reversals, adjustments, refunds or other methods. 12. Verifies claims adjudication utilizing appropriate resources and applications. Reconciles ... **Description** Summary: The Government-Non-government Specialist is responsible for reviewing, submitting and resolving assigned insurance accounts to an… more