- Merck & Co. (North Wales, PA)
- Job Description Overview: As a Senior Specialist in Business Analytics and Insights at our Company's HHDDA, the successful candidate will play a pivotal role in ... that address key business questions aligned with business priorities. The Senior Specialist will also measure the impact of promotional programs and provide… more
- Acosta Group (Dallas, TX)
- …some clients, this position will be responsible for creating promotions within client systems . The Claims Resolution Specialist will communicate with ... **DESCRIPTION** The Claims Resolution Specialist is responsible for...in Microsoft Office suite + Ability to learn client systems to be able to resolve claims … more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Recovery Specialist , Large Loss - Claims to play your part in that transformation. It's an ... guidelines and authority, indemnity and legal payments through the appropriate Claims Processing Systems . + Forecasts potential recoveries and updates… more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Claims Recovery Specialist to play your part in that transformation. It's an opportunity ... guidelines and authority, indemnity and legal payments through the appropriate Claims Processing Systems . + Forecasts potential recoveries and updates… more
- Axis (New York, NY)
- …platforms and systems including Bill Review systems such as Legal Exchange and claims systems as well as Word and Excel * College and/or other degree (JD ... for candidates taking part in the selection process. AXIS Capital Claims Compliance Specialist , Claims Shared Services- Job Description AXIS is seeking… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- Overview The Claims Specialist , under the direction of the Supervisor (with guidance from a Team Lead), is responsible for processing medical claims received ... and operational tools/ systems . This position utilizes ConnectiveRx and 3rd party systems to process claims and respond to inquiries from patients,… more
- CenterLight Health System (Flushing, NY)
- JOB PURPOSE: The Claims Specialist will support department operations related to provider communication, pended claim review, reporting, auditing, and oversight ... State, Federal, and contractual guidelines. JOB RESPONSIBILITIES: + The Claims Specialist will be responsible for reviewing...Provides feedback or suggestions to enhance current processes or systems . + Reviews and investigates claims to… more
- Prairie Ridge Health (Columbus, WI)
- Prairie Ridge Health is seeking a Claims Resolution Specialist to join the Business Services team. This position is a 1.0 FTE (40 hours per week) and works a ... Monday-Friday, day shift. The Claims Resolution Specialist is responsible for researching...payors to insure proper and maximum reimbursement. Uses multiple systems to resolve outstanding claims according to… more
- Robert Half Accountemps (Tucson, AZ)
- …the healthcare industry focused in Behavioral Health, is in need for a Medical Billing/ Claims specialist near downtown Tucson! You will be tasked with managing ... sharp candidates who are open to learning new EHR systems . Responsibilities: * Handle medical claims with...new EHR systems . Responsibilities: * Handle medical claims with precision and ensure timely processing * Utilize… more
- Whitney Young Health Center (Watervliet, NY)
- Claims Coding Specialist (Req 100825) Watervliet, NY (http://maps.google.com/maps?q=1601+Broadway+Watervliet+NY+USA+12189) Apply Description GENERAL ... RESPONSIBILITIES: Responsible for reviewing medical claims prior to submission and following up on more complex or problem claims or insurance types as… more
- City of New York (New York, NY)
- …is recruiting for four (4) Eligibility Specialists level II to function as a Claims Review Specialist , who will: - Review, process, determine and/or establish ... Job Description YOU MUST BE PERMANENT IN THE ELIGIBILITY SPECIALIST CIVIL SERVICE TITLTE OR IF YOU ARE HIRED PROVISIONALLY IN THE ELIGIBILITY SPECIALIST TITLE… more
- DoorDash (Tempe, AZ)
- …ambitious cross-functional partners at DoorDash. About the Role We are seeking an experienced claims specialist who will be a member of DoorDash's Corporate Risk ... company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are looking for forward… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ELIGIBILITY SPECIALIST CIVIL SERVICE TITLE OR IF YOU ARE HIRED PROVISIONALLY IN THE ELIGIBILITY SPECIALIST ... TITLE YOU MUST TAKE AND PASS THE ELIGIBILITY SPECIALIST CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE TO...data reporting. The areas are Centralized Data Entry (CDE), Claims & Collections (C&C), Division of Financial Review and… more
- Molina Healthcare (NM)
- …**Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, ... overpayment notification and supporting documentation such as explanation of benefits, claims and attachments. + Maintains and reconciles department reports for… more
- Prime Therapeutics (Eagan, MN)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Claims Specialist - Hybrid **Job Description** The Claims Specialist ... to incoming inquiries related to specific process or support systems (eg claim adjudication system) Escalate issues when appropriate...accredited institution or equivalent GED + 1 year of claims experience + Must be eligible to work in… more
- Santander US (East Providence, RI)
- Specialist , Claims & Fraud Operations East...the department and/or company. + Working knowledge of fraud systems such as Lexus Nexus, Targus, Tran Union TLO ... + Completes governmental reports such as SAR. + Investigates fraud claims involving ACH, Pre-authorized drafts, altered check, forged endorsements, unauthorized… more
- The Hartford (Naperville, IL)
- Operations Support Specialist , Claims - CH10KN We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and ... team as we help shape the future. The Hartford's Claims Centralized Operations Group is seeking a highly motivated...may vary based on upon need * Utilizing claim systems and equipment to correctly process incoming and outgoing… more
- Pacific Medical Centers (Seattle, WA)
- **Description** Adjudicates all claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions. Adjusts ... complex claims for advanced processing needs. Responds to Customer Service...HMO, PHO or large group practice setting. + Information systems supporting the administration of managed care products. +… more
- MetLife (Cary, NC)
- …* Independently manage an assigned caseload of the most complex claims which consists of pending, ongoing/active and appeal reviews. Provides timely, ... balanced and accurate claims reviews, documentation and recommended decisions in a time...thinking while having the ability to effectively manage multiple systems and technology resources/Organizational and time management skills. Preferred:… more
- Public Consulting Group (Chula Vista, CA)
- …+ Assessments and Feasibility Studies PCG is seeking highly motivated and dependable Claims Specialist payment processing clerk with an interest in public ... practices; efficient with computers. Demonstrated ability to use various computer systems , preferably CalSAWS and KinderTrak, althoughnot required. + Ability to… more
