• Medical Audit Claim Reviewer

    Point32Health (Canton, MA)
    …organization. **Key** **Responsibilities/Duties** **- what you will be doing** + Review and audit medical claims to ensure accuracy, completeness, and ... Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** As a Medical Audit Claim Reviewer, you will play...crucial role in our organization by reviewing and auditing medical claims to ensure compliance with policies,… more
    Point32Health (08/21/24)
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  • Claims Specialist, Audit

    LogixHealth (Bedford, MA)
    Location: On-Site in Bedford, MA This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We offer a… more
    LogixHealth (08/06/24)
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  • Medical Biller - Healthcare Claims

    Guidehouse (Lewisville, TX)
    …is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other ... Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides...or insurance information. + Works all rejection and payer audit reports within 48 hours of receipt taking whatever… more
    Guidehouse (09/01/24)
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  • Property Claims Specialist

    Axis (Princeton, NJ)
    …upon request for candidates taking part in the selection process. AXIS is seeking a ** Claims Specialist** to join our North America Claims team reporting to the ... Manager of Property Claims . This position requires claims management and handling expertise for both the oversight and management of TPA handled claims . This… more
    Axis (09/24/24)
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  • Workers' Compensation Claims Representative…

    Metropolitan Council (St. Paul, MN)
    …to our organization and the Twin Cities region: TheWorkers' Compensation Claims Representativewill administer Minnesota lost time and medical -only Workers' ... and pursue subrogation, as appropriate. + Participate in bi-annual claims meetings with internal departments. + Review medical...or management job; is in the Finance, Information Services, Audit , or Human Resources departments; or has access to… more
    Metropolitan Council (09/20/24)
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  • Claims Specialist I

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …Diploma or equivalent required **Work Experience** + 6 months of experience in medical claims or health insurance-related customer service or the successful ... with additional coverage plans) in order to process both coordinated and non-coordinated claims correctly. Requesting of medical records may be required. +… more
    Blue Cross and Blue Shield of Louisiana (09/23/24)
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  • Lead Claims Specialist

    Providence (Mission Hills, CA)
    **Description** Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Monitor check run process ... for accuracy. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative… more
    Providence (08/23/24)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (West Hills, CA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Team Lead - Workers Compensation REMOTE w/ CA Claims Exp.… more
    Sedgwick (07/23/24)
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  • Claims Team Lead, Professional Liability…

    Sedgwick (Long Beach, CA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements and ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Team Lead, Professional Liability (Hybrid) ) **PRIMARY PURPOSE** **:** To… more
    Sedgwick (09/30/24)
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  • Claims Team Lead - Workers Comp…

    Sedgwick (San Diego, CA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Team Lead - Workers Comp | Roseville, CA...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
    Sedgwick (09/19/24)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (Syracuse, NY)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Team Lead - Workers Compensation | NY Jurisdiction **PRIMARY PURPOSE:** To… more
    Sedgwick (09/13/24)
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  • Claims Team Manager - Media/E&O/Cyber

    Axis (Red Bank, NJ)
    …is available upon request for candidates taking part in the selection process. ** Claims Team Manager - Media/E&O/Cyber** **New York New Jersey Metro or Kansas City ... will report to the Head of North American Cyber Claims . The Claim Team Manager will lead and develop...drive brand + Leading and participating in claim audits, audit wrap up meetings, and formal result reporting +… more
    Axis (08/20/24)
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  • Quality Assurance Manager, Customer Claims

    GAF (Parsippany, NJ)
    …QS/PDC Audit standards. + Maintain RCN back-up capability within Claims Evaluation Lab. Perform other duties/projects as assigned. **Competencies and Skills** + ... we protect what matters most. **SUMMARY** Management of the Claims Evaluation Lab. Manage the overall Claims ...a wide range of health insurance options that include medical , dental and vision for you and your family.… more
    GAF (07/19/24)
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  • Senior Claims Specialist - Surety

    Axis (Alpharetta, GA)
    …AXIS is seeking a _Senior Claim Specialist_ _-_ _Surety_ to join our North America Claims team. This role will report to the Head of TPA & Programs Claims ... direct report to the Head of TPA & Programs Claims , the candidate should possess the ability to handle...claim trends + Leading and participating in claim audits, audit wrap up meetings, and formal result reporting +… more
    Axis (07/17/24)
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  • Liability Claims Representative PD

    Old Dominion Freight Line (Thomasville, NC)
    …pay as needed + Review financial information and determining settlement of downtime claims + Audit and process independent adjuster invoices + Write settlement, ... keep OD the premier transportation solutions provider. Effectively handle property damage claims due to OD vehicle accidents and incidents. Perform other duties… more
    Old Dominion Freight Line (09/10/24)
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  • Vice President, Health Plan Claims

    Prime Healthcare (Ontario, CA)
    Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of Claims data, the VP will identify financial ... members to join our corporate team! Responsibilities TheVice President of Health Plan Claims and Operations is responsible for the development and execution of Claim… more
    Prime Healthcare (08/29/24)
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  • MediGold Manager, Claims Operations

    Trinity Health (Columbus, OH)
    …a wide variety of professional roles including information technology, financial analysis, audit , provider relations and more. We know that exceptional patient care ... thing. **What we offer:** + Competitive compensation and benefits packages including medical , dental, and vision coverage + Retirement savings account with employer… more
    Trinity Health (09/06/24)
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  • Claims Manager Workers Compensation…

    Sedgwick (Roseville, CA)
    …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Manager Workers Compensation - (Hybrid Schedule) **PRIMARY PURPOSE** : To ... Establishes policy and procedure to ensure compliance to best practices, claims management services standards, state regulations and client service requirements;… more
    Sedgwick (09/04/24)
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  • Customer Service Rep; Insurance Claims -…

    TEKsystems (Liberty Lake, WA)
    …SERVICE REPS. TO SUPPORT NEW AND EXISITNG CLIENTS TOWARDS SIGNING UP, EXISTING CLAIMS , EDUCATING AND TO PROVIDE OVERALL CLARITY AND SUPPORT OVER THE PHONE. DIRECT ... inbound and outbound telephone service calls with respect to claims First Notice of Loss (FNOL), glass, towing and...Adheres to the standards put forth in call strength audit guidelines * Actively works to increase product knowledge… more
    TEKsystems (09/28/24)
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  • Supervisor - Claims Specialist Team

    University of Washington (Seattle, WA)
    …$4,664.00 - $6,673.00 per month Shift: First Shift Notes: + Choose from top medical and dental insurance programs + Plan for your future with tax-deferred investing ... Practice Plan Services (FPPS)** has an outstanding opportunity for a **full-time, day shift, CLAIMS SUPERVISOR.** **WORK SCHEDULE** + 40 hours per week + Day Shift +… more
    University of Washington (08/16/24)
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