- Harbor Health Services, Inc. (Mattapan, MA)
- …Management & Quality Programs. Harbor Health offers an excellent, comprehensive benefits package including Health, Dental, Vision, Life, & Disability insurance, 403b ... compliance with all contract requirements, as well as state and federal regulatory requirements; maintains audit-ready status. Creates a continuous learning culture… more
- CVS Health (Raleigh, NC)
- …effective communication skills. **What you will do** + Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, ... healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling...and guidelines. + Determines the eligibility and coverage of benefits for each claim based on the… more
- Community Health Systems (La Follette, TN)
- …accordance with regulatory guidelines and organizational policies. The Medicare Billing Specialist supports compliance with federal and state billing regulations ... **Job Summary** The Medicare Billing Specialist is responsible for performing timely and accurate Medicare billing activities, including claims preparation,… more
- Commonwealth of Pennsylvania (PA)
- …and Training Requirements: + Two years of experience as a Corrections Records Specialist (Commonwealth job title or equivalent Federal Government job title, as ... Contact Phone ### Contact Email ###@pa.gov + Description + Benefits + Questions THE POSITION Are you ready to...;or + One year of experience as a Records Specialist 2 (Commonwealth job title or equivalent Federal… more
- CVS Health (Hartford, CT)
- …- Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for ... handle customer service inquiries and problems. **Additional Responsibilities** - Reviews pre-specified claims or claims that exceed specialist adjudication… more
- Commonwealth of Pennsylvania (PA)
- …Experience and Training Requirements: + Two years as a Vocational Rehabilitation Specialist (Commonwealth job title or equivalent Federal Government job title, ... Vocational Rehabilitation Specialist Supervisor Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5173251) Apply Vocational Rehabilitation … more
- Commonwealth of Pennsylvania (PA)
- …Experience and Training Requirements: + Two years as a Fire Services Education Specialist (Commonwealth job title or equivalent Federal Government job title, as ... Fire Services Education Specialist Supervisor Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5172102) Apply Fire Services Education … more
- CVS Health (Bismarck, ND)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- CVS Health (Franklin, TN)
- …do** + Executes both routine and non-routine business support tasks for the Claim Benefit area under limited supervision, referring deviations from standard ... Description **A Brief Overview** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. **What you… more
- CVS Health (Oklahoma City, OK)
- …all the way! This is a fulltime teleworker opportunity in Oklahoma. The **Senior Claim Data Specialist ** handles end-to-end processes associated with claim ... related to new business/account implementations. **Fundamental Components:** + Reviews pre-specified claims or claims that exceed specialist adjudication… more
- HUB International (Wilmington, MA)
- …own unique, regional culture. We currently have an opportunity for a **Senior Claims Specialist ** . **Overview** : Responsible for servicing assigned accounts on ... : + Provides advocacy for small, middle market, and high-profile clients by reporting claims . + Participate in the claim after hours program as part of… more
- AssistRx (Phoenix, AZ)
- …of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim reversals, ... The Copay Support/ Claims Processing Specialist is a critical...enrollment discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing… more
- Cedars-Sinai (Los Angeles, CA)
- …arise. **Department specific responsibilities include:** Analyzes, trends, reports out, and resolves pended claims in PB Claim Edit WQs and PB Payer Rejection ... claim submissions and timely reimbursement. Completes special PB claims related projects as assigned. These projects could include...**Req ID** : 13216 **Working Title** : Revenue Cycle Specialist III (PB Claims ) **Department** : CSRC… more
- Molina Healthcare (Kearney, NE)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... notifications and provides supporting documentation such as explanation of benefits (EOBs), claims and attachments. * Maintains...claims as a refund or auto debit in claim systems and in recovery application. * Follows department… more
- Mass Markets (Killeen, TX)
- …industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong critical ... hear from you. This role involves handling inbound communications, evaluating warranty claims , and working closely with customers and service partners to ensure… more
- HUB International (St. Louis, MO)
- …resolutions for customers during stressful transitions. **Summary of the** **Role:** The Personal Effects Claims Specialist is a key member of ANOVA's Claims ... attorneys; technology that simplifies quotes and speeds up coverage; and experienced claims people who understand the challenges our clients face, with the authority… more
- Travelers Insurance Company (St. Paul, MN)
- …level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/ benefits / . ... Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is… more
- AAA Mid Atlantic (Cincinnati, OH)
- …parties when a claim is processed with carrier, providing accurate and timely claim information. + Continuously monitor claims until claims are closed by ... are looking for someone who will + Manage the claims reporting process for agency clients. + Report ...maintain records in the agency management system by documenting claim actions in accordance with established procedures. + Follow… more
- Kelly Services (Honolulu, HI)
- **NOW HIRING: Temp-to-Hire Claims Specialist - Dental Agency (Honolulu, HI)** **Now Hiring: Claims Specialist ** **Location:** Honolulu, Hawaii **Pay ... Join a reputable dental agency in Honolulu as a Claims Specialist ! Under the supervision of the...with HDS rules and guidelines + Process coordination of benefit claims **Other Duties and Responsibilities** +… more
- Zurich NA (Springfield, IL)
- RCIS Crop Claims Specialist 129020 Zurich is currently looking for a to join our Rural Community Insurance Services (RCIS) team. RCIS is one of the leading crop ... options, supplemental and stand-alone insurance products as well as federal crop insurance plans through the United States Department...and ranchers. Zurich is looking for an RCIS Crop Claims Specialist to work out of Illinois… more
