- MetLife (Oriskany, NY)
- …and manually adjudicate complex FEGLI Life claims to make claim determinations. *Provide UAT support for system enhancements. Typical Qualification ... and input information into a Power Builder computer claim system computer system *...* Interpret policy provisions and manually adjudicate FEGLI Life claims to make claim determinations. * Work… more
- Dignity Health (Rancho Cordova, CA)
- …are vital to maintaining excellence in care and service. **Responsibilities** The Senior Claims Examiner responsibilities include Quality Review of Claims ... of Dignity Health - one of the largest health systems in the nation - with hospitals and care...and the accuracy of member denial letters. The Senior Claims Examiner reviews all provider payment inquiries… more
- CACI International (Chantilly, VA)
- Senior Claims Examiner Job Category: Finance and... claim form and enter it into the claims system + Maintain worker's compensation ... of Travel: None * * * **The Opportunity:** We are seeking a detail-oriented and experienced Claims Examiner to manage and review workers' comp claims . As a … more
- State of Massachusetts (Boston, MA)
- *Lead Claims Examiner /Job Service Representative II| Department of Family & Medical Leave* The Program Integrity Claims Examiner /Job Service ... processes within the Department of Family Medical Leave (DFML). The Lead Claims Examiner /Job Service Representative II will review, analyze and evaluate… more
- State of Georgia (Fulton County, GA)
- Claims Examiner Georgia - Fulton -...recommendation regarding claim eligibility. + Accurately document claims in the claims management system ... an advisory compacity to the Governor on issues impacting the criminal justice system . CJCC plans & administers tens millions of dollars in federal criminal justice… more
- Fallon Health (Worcester, MA)
- …or follow us on Facebook, Twitter and LinkedIn. **Brief Summary of purpose:** The Claims Examiner should have thorough claim processing knowledge at a ... **Overview** **The Claims Examiner position is a hybrid...systems and manually apply rates in the core system . + Resolution of complex and high dollar … more
- Cedars-Sinai (CA)
- …standard of patient care we strive for. **What will you be doing:** The Claims Examiner is responsible for accurately and consistently adjudicating claims ... people throughout Los Angeles and beyond. **Req ID** : 6771 **Working Title** : Claims Examiner (Managed Care) - Remote **Department** : MNS Managed Care… more
- LA Care Health Plan (Los Angeles, CA)
- Claims Examiner I Job Category: ...* Reviewing claims for required information, pending claims when necessary, maintaining a follow-up system , ... and to support the safety net required to achieve that purpose. Job Summary The Claims Examiner is responsible for the accurate and timely processing of direct… more
- ICW Group (Woodland Hills, CA)
- …with opportunities to contribute, develop, and belong. **PURPOSE OF THE JOB** The Senior Claims Examiner handles moderate to complex claims with a focus ... within Company standards and best practice guidelines. The Senior Claims Examiner works with a sense of...industry's best practices. + Ensures accuracy of data in claims system for compliance with applicable regulatory… more
- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner ** **(Initial Training on Site - 30 days - Remote after training)** **Must live within a reasonable ... FL** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims Examiner adjudicates medical claims based on… more
- Sedgwick (New York, NY)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Examiner | NY Jurisdiction | Dedicated Client We are ... payment timelines, and compliance with statutory requirements. + Negotiate settlements of claims within designated authority to reach claim resolution. + Provide… more
- GAF (Parsippany, NJ)
- …to assist with their issues in the most expedient and informative way. The Warranty Claims Examiner will be responsible for overseeing the residential claims ... what matters most. **Job Summary** The goal of the Claims Department is to provide solutions-based service driven by...preparation of various communications throughout the life of the claim , and resolution. + Provide front-line support related to… more
- ADP (San Dimas, CA)
- …state-of--the art predictive modeling, and metrics, data analytic tools and HRIS and claims systems . + Requires comprehensive knowledge of CA and western region ... ADP is hiring a Claims Lead Examiner . _RESPONSIBILITIES:_ + Assist...department and company goals. + Monitor and ensure qualitative claim handling through TPA and other vendor partners. +… more
- Molina Healthcare (MI)
- …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims processing… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- Title: RETIREMENT CLAIMS EXAMINER Location: United States-Virginia-Virginia Beach Job Number: 240003CP Job Summary: Performs duties relating to the ... annuity payment. Establish and initiate retirement payment accounts in retirement vendor system . Input all retire personal data tax deductions and survivor annuity… more
- Louisiana Department of State Civil Service (Shreveport, LA)
- Disability Determinations Examiner 1/2/3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4777517) Apply Disability Determinations Examiner ... have access to Social Security disability data, records, and systems . Your conditional job offer and access to Social...be filled from this recruitment as a Disability Determinations Examiner 1,2,or 3 depending on the level of experience… more
- Commonwealth of Pennsylvania (PA)
- Driver License Examiner (Jeannette) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4795648) Apply Driver License Examiner (Jeannette) ... + One year of experience as a Driver License Examiner Assistant (commonwealth title); or + Two years of...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- The County of Los Angeles (Los Angeles, CA)
- EVIDENCE CUSTODIAN, MEDICAL EXAMINER Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4735723) Apply EVIDENCE CUSTODIAN, MEDICAL EXAMINER ... Angeles County, CA Job Type Full time Job Number P2297A-R Department MEDICAL EXAMINER Opening Date 01/08/2025 Closing Date 1/24/2025 5:00 PM Pacific + Description +… more
- Commonwealth of Pennsylvania (PA)
- Driver License Examiner Assistant (Bridgeville) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4794718) Apply Driver License Examiner ... for candidates to fill the role of Driver License Examiner Assistant. This position plays a crucial role in...and input data into the online driver license application system . You will administer standardized knowledge assessments to gauge… more
- ICW Group (Lisle, IL)
- …lost time. This position exists to reserve, manage, and bring Workers' Compensation claims to an equitable conclusion within the company standards and best practices ... DUTIES AND RESPONSIBILITIES** Receives and reviews information related to Medical Only claims . + Communicates via mail, phone, and email with injured workers,… more