- Cedars-Sinai (CA)
- …people throughout Los Angeles and beyond. **Req ID** : 11588 **Working Title** : Claims Examiner - Managed Care **Department** : MNS Managed Care ... **Job Description** The Claims Examiner is responsible for accurately...is a leader in providing high-quality healthcare encompassing primary care , specialized medicine and research. Since 1902, Cedars-Sinai has… more
- WelbeHealth (Nashville, TN)
- …team helps ensure excellent care delivery for our participants, and the Claims Examiner plays a pivotal role in ensuring timely and efficient processing ... three (3) years of experience with processing, researching, and adjudicating claims in a complex managed care environment + Working knowledge of the health… more
- Centene Corporation (Frankfort, KY)
- …Outlook, PowerPoint, Word, Xcelys, SalesForce, and Microsoft Access. Knowledge and understanding of managed care claims processing systems and medical ... audit and risk analysis. 1+ year of experience in managed care or health insurance company. **Candidate...one of the following is required: Other Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner… more
- Molina Healthcare (Covington, KY)
- …lieu of education experience) + At least five (5) years' experience working in a Managed Care Organization or health insurance company + Minimum of two (2) ... investigative and law enforcement procedures with emphasis on fraud investigations + Knowledge of Managed Care and the Medicaid and Medicare programs as well as… more
- Sedgwick (Memphis, TN)
- …reports, claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care ; transfers payment allocations; and ... Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple...logins and the applicable security access for the company's claims management systems by determining the validity for incoming… more