- MAG Industries LTD (Tyrone, PA)
- …team. This position is responsible for managing customer credit requests, processing returns, evaluating discrepancies, and ensuring that all credits and adjustments ... ensuring accuracy and compliance with company policies * Evaluate return claims , validate supporting documentation, and determine eligibility based on established… more
- Eric Jaslow - State Farm Agency (Nyack, NY)
- …take corrective actions when necessary. May be involved in managing budgets, processing daily deposits, and handling payroll and bookkeeping in smaller agencies. ... responding to inquiries regarding policy changes, coverage, billing, and claim submissions. Relationship management: Establish strong customer relationships and… more
- AssistRx (Phoenix, AZ)
- …Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim ... duplicates) + Partners with claim adjudication vendors ensure proper claims processing and data integrity. + Monitor and remediate medical and pharmacy… more
- MyFlorida (Tallahassee, FL)
- CLAIMS PROCESSING SUPERVISOR - 36000333 Date:...to team members. Assist in preparing the How to Claim web page information for all new promotions. + ... . Requisition No: 866202 Agency: Department of Lottery Working Title: CLAIMS PROCESSING SUPERVISOR - 36000333 Pay Plan: Lottery Exempt Serv Position Number:… more
- IQVIA (Phoenix, AZ)
- **Patient Support Medical Claims Processing Representative** _Remote Role - Location (Open to Remote US)_ As the only global provider of commercial solutions, ... 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team....+ High School Diploma or equivalent + Experience in claim processing required + Medical Billing Certification… more
- Boston Mutual Life Insurance (Canton, MA)
- …Executive Vice President of Customer Experience. This role will also manage our external claims partners. ** Claim Processing ** : + Directs and oversees the ... handling of all insurance claims . + Ensure timely and accurate claim processing . + Implements processes and procedures for all aspects of claims . +… more
- Ryder System (Augusta, ME)
- …claims within Ryder's self-insured, self-administered liability program. Oversees claim -handling processes performed by a professional staff. Handles complex ... action plans if deficiencies are noted. Monitors staff's workflow to ensure accurate processing of claims , timely establishment of reserves, reviews and logs… more
- MVP Health Care (Rochester, NY)
- …and Macess Systems. + Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + ... continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a...Reviews and ensures the accuracy of all changes to claim line information based on information received from other… more
- CVS Health (Raleigh, NC)
- …communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing . Contributes to the efficient and accurate handling ... stakeholders to resolve any discrepancies or issues related to claims . + Determines if claims processing...multiple systems at once to resolve complex issues. + Claim processing experience preferred but not required.… more
- AIG (Lenexa, KS)
- …party contractors or by internal claim handling teams associated with the processing of commercial or personal line claims . + Generate monthly reports that ... need to succeed + Proven claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience is… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims processing to join our team in Plano, Texas (US-TX), United ... will** **be responsible for:** + Review and process insurance claims . + Validate Member, Provider and other Claim... claims . + Validate Member, Provider and other Claim 's information. + Determine accurate payment criteria for clearing… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims processing to join our team in Plano, Texas (US-TX), United ... In these roles you will be responsible for: Review and process insurance claims . Validate Member, Provider and other Claim 's information. Determine accurate… more
- Travelers Insurance Company (San Diego, CA)
- …As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer ... claims handling process **What Will You Do?** + Provide quality claim handling of auto claims including customer contacts, coverage, investigation,… more
- Sedgwick (Plano, TX)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Molina Healthcare (Buffalo, NY)
- …updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these ... communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims … more
- CVS Health (Bismarck, ND)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process ... dollar amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage,… more
- Travelers Insurance Company (West Bridgewater, MA)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site...mail. Orders, receives and distributes supplies and/or equipment. + CLAIM PAYMENTS AND EXPENSE PROCESSING : Ensures the… more
- CVS Health (Tallahassee, FL)
- …+ 3+ years of experience in medical billing and coding, specifically related to claims processing and root cause analysis. + 3+ years of experience with ... non-participating providers. Additionally, they will assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as… more
- Providence (Mission Hills, CA)
- …of functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. ... Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Claims Processing + **Schedule:** Full Time, Days + **Facility:** Ascension Medical Group + **Location:** Jacksonville, FL ... party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review … more
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