- Molina Healthcare (Columbus, OH)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- CenterWell (Jefferson City, MO)
- …+ High School Diploma or the equivalent + Minimum of two years medical claims processing experience preferred + Knowledge of healthcare collection procedures and ... agencies, and the timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate… more
- Molina Healthcare (MI)
- …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 ... resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to… more
- Molina Healthcare (Columbus, OH)
- …remediation plans and fixes, overall progress, and status of impacted claims **JOB QUALIFICATIONS** **Required Education** Associate 's Degree or equivalent ... **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing requirements (1500 and UB04), provider and benefit… more
- Nestle (Bohemia, NY)
- …health and nutrition for patients and consumers. **Job Description:** The Customer Solutions & Claims Associate will serve as the primary point of contact for ... When fulfilling order management duties, the Customer Solutions & Claims Associate will also be responsible for...package, which includes a 401(K) with a company match, healthcare coverage and a broad range of other benefits.… more
- Molina Healthcare (Long Beach, CA)
- …advanced Excel or SQL. + Must be able to conduct root cause analysis in Healthcare Porvider claims data.. + Experienced in Healthcare domain specifically ... HS Diploma or GED **Required Experience** 0-1 year **Preferred Education** Associate degree or equivalent combination of education and experience **Preferred… more
- Humana (Miramar, FL)
- …a part of our caring community and help us put health first** The Claims Processing Representative reviews and adjudicates complex or specialty claims , submitted ... or electronically while performing basic administrative/clerical/operational/customer support/computational tasks. The Claims Processing Representative determines whether to return, deny, or… more
- Dignity Health (Bakersfield, CA)
- … Examiner II is responsible for the efficient and accurate processing of healthcare claims . This role involves reviewing, analyzing, and adjudicating claims ... Qualifications:** + Minimum of 2-4 years of experience in healthcare claims processing or a related field....is highly desirable. + Associate 's Degree - Associate 's degree in healthcare administration, business, or… more
- Humana (Green Bay, WI)
- …a part of our caring community and help us put health first** The Claims Research & Resolution Representative 3 manages claims operations that involve customer ... contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The … more
- Dignity Health (Bakersfield, CA)
- …responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims . This position requires expert knowledge of claims ... **Qualifications** **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing, with at least 2...and medical terminology. + Associate 's Degree - Associate 's Degree in healthcare administration, business, or… more
- Providence (OR)
- …in Salem, Oregon **Required Qualifications:** + 1 year - Experience in a Associate Claims Specialist position **Preferred Qualifications:** + Bachelor's Degree + ... 1 year of experience with healthcare customer service and/or claims , accounting **Why Join Providence Health Plan?** **Our** **best-in-class benefits** **are… more
- University of Utah Health (Murray, UT)
- …that are integral to our mission. EO/AA_ + This position is responsible for auditing claims and customer service calls for UUHP. + The Claims and Customer ... Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1...Performs routine and complex audits on phone calls and claims adjudication. + Researches claim processing problems and errors… more
- UPMC (Pittsburgh, PA)
- **Purpose:** The function of the Associate Accounts Receivable Claims Analyst is to ensure all HRA, FSA , ASO & Stop Loss related reporting & reconciliation, ... claims utilization billing, and employer group reimbursements are completed...related field preferred + Minimum of 1 year of healthcare , insurance, or other financial experience required + Demonstrate… more
- Humana (San Juan, PR)
- …of our caring community and help us put health first** The Supervisor, Claims Processing reviews and adjudicates complex or specialty claims , submitted either ... via paper or electronically. The Supervisor, Claims Processing works within thorough, prescribed guidelines and procedures; uses independent judgment requiring… more
- Kelly Services (Glastonbury, CT)
- **Now Hiring: Claims Specialist - Medical Claims (Bilingual)** **Position:** Claims Specialist - Medical Claims (Bilingual) **Salary:** $22 - $23/Hour ... Spanish Speaking **Job Summary:** We are seeking a dedicated and detail-oriented Claims Specialist to join our fast-paced environment. The ideal candidate will have… more
- Hackensack Meridian Health (Eatontown, NJ)
- …community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. Responsible for long-term care ... the pharmacy operations team to ensure timely submission and resolution of prescription claims . **Responsibilities** A day in the life of a Pharmacy Claims … more
- UNUM (Chattanooga, TN)
- …candidates to fill various roles related to managing leave requests and disability claims . When you apply, you'll be considered for positions such as Integrated Paid ... Leave Specialist, STD Benefits Specialist Trainee, Associate Leave Specialist, Eligibility Specialist and Associate ...+ Handle leave, short-term disability (STD), or paid leave claims efficiently and accurately. + Determine if employees are… more
- DriveTime (Mesa, AZ)
- …which provides quality warranty and ancillary products, and a customer-friendly claims process. SilverRock offers a variety of ancillary products and administrative ... contracts, products, and warranties, and over $300 million in claims . **That's Nice, But What's the Job?** In short,...optimistic attitude. **The Specifics.** + High School diploma required; Associate or Bachelor's deree is preferred + 3 +… more
- Humana (Columbus, OH)
- …elevate your pharmacy career by driving meaningful impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a ... development of solutions that make a meaningful difference The Senior Pharmacy Claims Professional will play a pivotal role in Pharmacy Financial Recovery… more
- Signature Healthcare (Louisville, KY)
- Signature HealthCARE is a family-based healthcare company that offers integrated services in 7 states across the continuum of care: skilled nursing, ... Work for three years in a row and Modern Healthcare 's "Best Places to Work!" This position will be...be limited to: managing administrative (survey) and other legal claims against company; interfacing with outside legal counsel; administering… more