- MyFlorida (Tallahassee, FL)
- …and effectiveness, and safeguarding Lottery assets, and internal controls. + Effectively lead Claims Processing Service Improvement Teams (SITs) to ... CLAIMS PROCESSING SUPERVISOR - 36000333 Date:...outcomes that create efficiencies within the division. + Effectively lead their assigned team and performing administrative functions related… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- …of the Supervisor (with guidance from a Team Lead ), is responsible for processing medical claims received from patients and/or HCPs across a broad product ... rules external to the systems. Consult with the Team Lead or Supervisor for complex claims or...Health care or pharmaceutical experience, particularly in a medical claims processing , billing provider, or insurance environment… more
- CVS Health (Hartford, CT)
- …and leading modernization efforts. + Strong understanding of regulatory compliance in claims processing . ** ** **Preferred Experience** + Excellent communication ... do it all with heart, each and every day. **Position Summary:** The Lead Director of Software Engineering is responsible for leading engineering teams that support… more
- Ford Motor Company (Livonia, MI)
- …Expert (SME) for claims administration and processing + Administer dealer claims for US Dealers + Lead PartTrac claims return process integration ... both virtually and in person. **What you'll do ** + Manage and own the Claims Processing and support teams + The Claims Team are Schneider Logistics (SLI)… more
- US Tech Solutions (Myrtle Beach, SC)
- …after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards. ... Type** : High School Diploma or equivalent + **Required Work Experience:** Experience processing , researching and adjudicating claims + **Experience:** 1 year of… more
- Centene Corporation (Indianapolis, IN)
- …or equivalent experience. 4+ years of related Heath insurance or claims processing experience. Previous experience as a lead in a functional area, managing ... or CPT.** **Position Purpose** Manage the prospective review of high risk claims to ensure payment integrity and provide immediate feedback on findings including… more
- Walmart (Bentonville, AR)
- …data. **Technology & Industry Awareness** + Maintain current knowledge of insurance, claims processing , and TPA industry trends, regulations, and best practices. ... and fellow Senior Directors to set the strategic direction, operational excellence, and lead transformation of the Claims Services department. This leader will… more
- JB Hunt Transport (Lowell, AR)
- …investigate claims , negotiate settlements, and prepare reports to ensure accurate and timely processing of casualty claims . This role will serve as a team ... lead to less experienced team members, lead initiatives when claims should be escalated to additional professionals, and provide settlement authority within… more
- Trinity Health (Livonia, MI)
- …behavior. **MINIMUM QUALIFICATIONS** Must possess a comprehensive knowledge of liability claims processing and administration. High school diploma plus a ... I_** **_nsurance experience is highly preferred, particularly if it was in claims ._** **_**_** **_Any experience with state reporting requirements or hospital risk… more
- AIG (Atlanta, GA)
- …of smaller vendors with an annual spend of less than $500K for Insurance Claims processing and adjudication commodities. This includes: + + Negotiate commercial ... About the role Reporting directly to the Claims Sourcing Manager, the role will be responsible...be a preferred AIG panel vendor; + Participate and lead vendor pricing negotiations; + Document and summarize the… more
- CVS Health (Annapolis, MD)
- …quality assurance, and compliance monitoring. This role ensures timely and accurate processing of Medicaid claims in accordance with state and federal ... all with heart, each and every day. **Position Summary** The Manager of Claims Management is responsible for overseeing Medicaid claims operations, inventory… more
- CHS (Clearwater, FL)
- … claims prior to payment. * Oversight for the ongoing management of claims processing technology, including plan building and identification of new and ... the client's stated coverage. Join Premier Administrative Solutions as a Claims Manager and lead our Claims Department in delivering exceptional service to… more
- Dignity Health (Bakersfield, CA)
- …of complex healthcare claims . This position requires expert knowledge of claims processing , coding, and regulatory compliance. The Claims Examiner ... **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years...of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population… more
- CVS Health (Franklin, TN)
- …each and every day. **Position Summary** This role will have a focus on training Claims processing and Claims Call Center staff for all products including ... + This is an Individual Contributor role. **Responsibilities** + Lead training sessions for designated audiences + Actively engage...three (2-3) years of experience and understanding of Medicare claims processing and/or Healthcare claims … more
- Cedars-Sinai (Los Angeles, CA)
- …Professional Fee billing and collections. Duties include reviewing and submitting claims to payors, performing account follow-up activities, updating information on ... patient account, reviewing and processing credits, posting payments, and account reconciliations. Positions at...others and may act in the absence of the lead and/or supervisor. This position may be cross trained… more
- CVS Health (Hartford, CT)
- …This critical role involves addressing significant challenges related to enrollment, billing, and claims processing on the Majesco LA&H Core Suite. The ideal ... on resolving high-priority defects and systemic issues impacting enrollment, billing, and claims processing + Deep-Dive Analysis & Root Cause Identification:… more
- Percepta (Melbourne, FL)
- **Description** **Dealership Claims Consultant** At Percepta, we bring first-class service across each market we support. As a **Dealership Claims Consultant** ... being part of a unique culture **What You'll Be Doing** The Dealership Claims Consultant is responsible for accurate and consistent Extended Service Plan Prior… more
- AIG (Atlanta, GA)
- …smaller Law Firms with an annual spend of less than $500K for Insurance Claims processing and adjudication commodities. This shall include; + + Negotiate ... role will be responsible for supporting the contracting of claims Law Firms, engaging in the collection of Law...from AIG's Law Firm contract template; + Participate and lead Law Firm pricing negotiations; + Document and summarize… more
- Catholic Charities of the Dioscese of Albany (Albany, NY)
- …closeout reports + Update the Schedule of Expenditures of Federal Grants (SEFA) + Claims processing + Reconcile all 1115 Waiver bills submitted to funders with ... Your Career? Be the Change: Become the 1115 Waiver Grants/ Claims Manager at Catholic Charities! At Catholic Charities hiring...or a trained hiring manger! Are you ready to lead with purpose and passion? At Catholic Charities, we're… more
- The Hartford (Alpharetta, GA)
- …is hiring an AVP leading Generative and Agentic AI solutions for the Claims and Operations organizations. This leader will play a pivotal role in transforming ... the end-to-end Claims and Service customer journey by developing and embedding...and interactive solutions with a toolkit including Natural Language Processing , Computer Vision, Machine Learning, Generative AI and Agentic… more