- The Cigna Group (Bloomfield, CT)
- …accuracy of claim administration. + Evolve SLAs and oversees business partner claims processing and auditing to ensure SLAs are met, inclusive of ... accountability for Claims Monthly Operating Review, Claim Accuracy workgroup,...in a fast-moving environment If you will be working at home occasionally or permanently, the internet… more
- HCA Healthcare (Nashville, TN)
- …The Claims Auditor will serve as a Subject Matter Expert (SME) in medical claims processing at health plan payor, MSO, HMO, and IPA organizations with ... in you as a ** Claim Auditor** ? At Work from Home , you come first....primary function to ensure examiner payment accuracy of all claims processing including analysis of support services… more
- Crawford & Company (Fort Lauderdale, FL)
- …Content Claims Specialists are consistently (daily/weekly basis) assigned new claim files. + Operating from their home -based offices, edjuster's Content ... claims handling professional-service methodology and its Web-based content claims processing and pricing platform/system - exclaim....we are helping to restore our community - one claim at a time. At … more
- Axis (Red Bank, NJ)
- …analyze the claim exposure, determine the proper course of action, and pursue claims to conclusion Set accurate and timely claim reserves and make referrals ... team that is among the best in the industry. At AXIS, we believe that we are only as...these are processed accurately and promptly, including monitoring and processing of claims bordereaux and ISO searches… more
- Axis (Red Bank, NJ)
- …of action, and pursue claims to conclusion * Set accurate and timely claim reserves and make referrals to senior members of the team where necessary * Obtain ... team that is among the best in the industry. At AXIS, we believe that we are only as...these are processed accurately and promptly, including monitoring and processing of claims bordereaux and ISO searches… more
- Fallon Health (Worcester, MA)
- …LinkedIn. **Brief Summary of purpose:** The Claims Examiner should have thorough claim processing knowledge at a complex level.. Thorough understanding ... the office in Worcester, MA and 2 days working at home .** **About us:** Fallon Health is... claims . + Ensures accuracy and timeliness of claims processing to minimize late payment interest… more
- The Cigna Group (Bloomfield, CT)
- …of database management systems (DB2, SQL Server), preferred If you will be working at home occasionally or permanently, the internet connection must be obtained ... Matter Expert (SME) for the Configuration of the eviCore Claims Systems and the suite of eviCore Claim...years of experience as a subject matter expert for claims system configuration, processing , reporting, issue triage… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …training and/or direct work related experience. Experience Required: + Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company ... Medicaid Claims Analyst Date: Nov 19, 2024 Location: Parsippany,...+ Minimum 2+ years pharmaceutical/product focused healthcare experience; Medicaid Claim processing function; manipulation of large datasets,… more
- Apex Health Solutions (Houston, TX)
- …day to day interactions with any vendor partners that have direct impact to claims processing or pricing rules. Identifies and implements new processes, vendors, ... oversee user acceptance testing for any impacted changes to claims processing Demonstrate expertise in interpretation and...Serves as point of contact in researching and presenting Claim data in all legal issues Serves as company… more
- Armed Forces Benefit Association (Lincoln, NE)
- …operations and sales support role responsible for managing beneficiary and group relationships at point of claim . This position will be supporting the ... and Client Management teams where needed and provide group claims experience reporting for renewal processing . +...guidelines + Serve as the point of contact with Home Office Life Claims for communication +… more
- Sedgwick (Philadelphia, PA)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... Taking care of people is at the heart of everything we do, and...and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to… more
- Randstad US (Worcester, MA)
- …of experience is required) + Adjusting (2 years of experience is required) + Insurance Claim Processing (3 years of experience is required) + Field Adjusting (2 ... + May be responsible for all aspects of each claim , including informal hearings, arbitrations and small claims...+ May be required to have and maintain sufficient home -based internet connection + Xactimate experience preferred + Must… more
- Mass Markets (Wichita, KS)
- …monitor, and manage production supervisors and agents to ensure accurate and timely claims processing . Experience in BPO insurance contracts, claims , ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer… more
- HCA Healthcare (Nashville, TN)
- …appropriate accounts. Requirements + High school diploma or equivalent + Two (2) years of experience processing claims , with at least one year of claims ... join an organization that invests in you as a Claims Examiner? At Work from Home...CPT, HCPC, and Revenue Coding + Ability to analyze claim issues and "trouble shoot" claims problems… more
- New York State Civil Service (Albany, NY)
- …Cost Control Analyst reviews and recommends approval of construction change orders, analyzes claims , and participates in the negotiation of claim settlements on ... DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office Occupational Category Other… more
- HCA Healthcare (Campbell, CA)
- …when necessary. Requirements: + High school diploma + Three to Five years of experience processing regular and complex claims + Ability to act as a resource and ... Do you have the career opportunities as a Senior Claims Examiner you want with your current employer? We...+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans… more
- Apex Health Solutions (Houston, TX)
- …to day interactions with any vendor partners that have direct impact to claims processing or pricing rules. Responsible for hiring, orienting, training, ... key requirements Shall oversee user acceptance testing for any impacted changes to claims processing Provide escalation support for business or revenue impacting… more
- Pacific Medical Centers (Seattle, WA)
- …CHAMPUS, Medicare and/or Medicaid benefits/programs. + All areas of specialty claim processing (COB, Adjustments, Point of Service, Home Health, Home ... needs. Responds to Customer Service Requests and resolves problem claim situations. Assists in managing the workflow of assigned...Managed Care operations, including a minimum of 3 years claims processing experience, in a TPA, MSO,… more
- Acosta Group (Irving, TX)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... as needed + Uses systems, reports, and Standard Operating Procedures to work assigned claim steps and gather supporting claims information + Processes invalid … more
- CenterWell (Topeka, KS)
- …and support agency personnel encompassing all aspects of insurance and non-Medicare claims processing . + Prepare input data forms to update computer ... Specialist** , you will: + Ensure the coordination of claim activities and designated agencies, and the timely reimbursement...or the equivalent + Minimum of two years medical claims processing experience + Knowledge of healthcare… more